REM Sleep Behavior Disorder

2017 ◽  
Author(s):  
Shannon S. Sullivan
Keyword(s):  
Rem Sleep ◽  
Adult Population ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
The Elderly ◽  
Sleep Behavior ◽  
Muscle Atonia ◽  
General Adult Population ◽  
Sleep Environment ◽  
Neuroprotective Therapies

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia featuring often violent dream enactment behavior, which may lead to injury. Its polysomnographic hallmark is loss of physiological REM muscle atonia. Prevalence is unknown but estimated to be less than 1% of the general adult population, and as high as 6% in the elderly. It is an important risk factor for development of alpha-synucleinopathy, with a conversion rate of approximately 80% after 15 years. Treatments include safeguarding the sleep environment, and clonazepam and/or melatonin to reduce injury. In the future, RBD diagnosis may provide an opportunity for new neuroprotective therapies.

Neurobiology of REM sleep

2017 ◽  
Author(s):  
Pierre-Hervé Luppi ◽  
Olivier Clément ◽  
Christelle Peyron ◽  
Patrice Fort
Keyword(s):  
Rem Sleep ◽  
Paradoxical Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Simultaneous Excitation ◽  
Glutamatergic Neurons ◽  
Tegmental Nucleus ◽  
Muscle Atonia ◽  
Reticular Nuclei

REM (paradoxical) sleep is a state characterized by rapid eye movements, EEG activation, and muscle atonia. REM sleep behavior disorder (RBD) is a parasomnia characterized by loss of muscle atonia during REM sleep. Cataplexy, a key symptom of narcolepsy, is a striking sudden episode of muscle weakness comparable to REM sleep atonia triggered by emotions during wakefulness. This chapter presents recent results on the neuronal network responsible for REM sleep and explores hypotheses explaining RBD and cataplexy. RBD could be due to a specific degeneration of glutamatergic neurons responsible for muscle atonia, localized in the pontine sublaterodorsal tegmental nucleus (SLD) or the glycinergic/GABAergic premotoneurons localized in the ventral medullary reticular nuclei. Cataplexy in narcoleptics could be due to activation during waking of SLD neurons. In normal conditions, activation of SLD neurons would be blocked by simultaneous excitation by hypocretins of REM sleep-off GABAergic neurons localized in the ventrolateral periaqueductal gray.

scholarly journals Clinical Overview of REM Sleep Behavior Disorder

2017 ◽  
Vol 37 (04) ◽  
pp. 461-470 ◽  
Author(s):  
Verna Porter ◽  
Alon Avidan
Keyword(s):  
Rem Sleep ◽  
Muscle Tone ◽  
Clinical Manifestations ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Lewy Body Dementia ◽  
Acute Onset ◽  
Periodic Limb Movement Disorder ◽  
Sleep Behavior ◽  
Muscle Atonia

AbstractRapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by loss of muscle atonia during REM sleep that allows motor responses to dream content. Patients display patterns of unusual, complex, and even violent motor activities. There is a high risk for harm to the patients or their bedpartners. REM sleep behavior disorder is more likely to occur in synucleinopathies such as Parkinson's disease, Lewy body dementia, and multiple system atrophy and may precede clinical manifestations by decades. In secondary RBD, brainstem centers involved in muscle atonia during REM are disrupted. These conditions include multiple sclerosis, cerebral vascular accidents, and brainstem tumors. The acute onset of RBD may associate with the use of antidepressants and acute withdrawal from alcohol. The diagnosis of RBD should be confirmed by polysomnography utilizing multiple-limb electromyography and synchronized digital video monitoring and demonstrate elevation of muscle tone during REM sleep along with dream enactment behavior. The differential diagnosis includes sleepwalking, nocturnal seizures, sleep apnea, and periodic limb movement disorder. Management focuses on maximizing safety, use of clonazepam/melatonin, and discussion of prognosis with patients.

scholarly journals Prevalence and incidence of Parkinson’s disease and other forms of parkinsonism in a cohort of elderly individuals in Southern Brazil: protocol for a population-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054423
Author(s):  
Gabriela Magalhães Pereira ◽  
Nayron Medeiros Soares ◽  
Neide Maria Bruscato ◽  
Emilio Hideyuki Moriguchi ◽  
João Senger ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rem Sleep ◽  
Comprehensive Evaluation ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
The Elderly ◽  
Population Based ◽  
Population Based Study ◽  
Sleep Behavior

IntroductionParkinsonism is one of the most common neurological disorders affecting the elderly. Several population-based studies have determined the epidemiology of parkinsonism, mainly Parkinson’s disease (PD), but there is still little evidence in the Brazilian population. This protocol study aims to assess the prevalence and incidence of cases of PD and other parkinsonian syndromes in a 5-year cohort in a population-based study in the southern region of Brazil.Methods and analysisA prospective population-based longitudinal study, with a cohort of development of cases of parkinsonism, divided into two phases: in phase I, two questionnaires to screen for parkinsonism (Tanner’s questionnaire), Rapid Eyes Movement (REM) sleep behaviour disorder (REM Sleep Behavior Disorder Single-Question Screen) and a short interview will be conducted with all elderly residents of Veranópolis (the first longevity Brazilian county located in the Rio Grande do Sul, Brazil) aged 60 or over. The positive screened cases will be examined independently by at least two movement disorder-trained physicians and prevalence will be determined. A comprehensive evaluation of prodromic symptoms, risk factors and clinical characteristics will be carried out. Subjects with subtle parkinsonism and a sample of healthy subjects will be followed for 5 years in a developmental cohort of parkinsonism cases. For crude incidence, all individuals admitted at the beginning of the study will be re-evaluated.Ethics and disseminationThe study was approved by the research ethics committee of the Hospital de Clínicas de Porto Alegre (protocol n° 4.095.609). All participants provide their informed consent before evaluations. Findings from this survey will be disseminated through peer-reviewed publications and will be presented at conferences.

scholarly journals Neurophysiological Aspects of REM Sleep Behavior Disorder (RBD): A Narrative Review

2021 ◽  
Vol 11 (12) ◽  
pp. 1588
Author(s):  
Michela Figorilli ◽  
Giuseppe Lanza ◽  
Patrizia Congiu ◽  
Rosamaria Lecca ◽  
Elisa Casaglia ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Narrative Review ◽  
Vestibular Evoked Myogenic Potentials ◽  
Future Research ◽  
Sleep Behavior ◽  
Future Research Agenda ◽  
Muscle Atonia ◽  
The Many

REM sleep without atonia (RSWA) is the polysomnographic (PSG) hallmark of rapid eye movement (REM) sleep behavior disorder (RBD), a feature essential for the diagnosis of this condition. Several additional neurophysiological aspects of this complex disorder have also recently been investigated in depth, which constitute the focus of this narrative review, together with RSWA. First, we describe the complex neural network underlying REM sleep and its muscle atonia, focusing on the disordered mechanisms leading to RSWA. RSWA is then described in terms of its polysomnographic features, and the methods (visual and automatic) currently available for its scoring and quantification are exposed and discussed. Subsequently, more recent and advanced neurophysiological features of RBD are described, such as electroencephalography during wakefulness and sleep, transcranial magnetic stimulation, and vestibular evoked myogenic potentials. The role of the assessment of neurophysiological features in the study of RBD is then carefully discussed, highlighting their usefulness and sensitivity in detecting neurodegeneration in the early or prodromal stages of RBD, as well as their relationship with other proposed biomarkers for the diagnosis, prognosis, and monitoring of this condition. Finally, a future research agenda is proposed to help clarify the many still unclear aspects of RBD.

scholarly journals Can Corticomuscular Coherence Differentiate between REM Sleep Behavior Disorder with or without Parkinsonism?

2021 ◽  
Vol 10 (23) ◽  
pp. 5585
Author(s):  
Gyeong Seon Choi ◽  
Ji Young Yun ◽  
Sungeun Hwang ◽  
Song E. Kim ◽  
Jeong-Yeon Kim ◽  
...  
Keyword(s):  
Clinical Features ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Stages ◽  
Motor Symptoms ◽  
Limb Muscle ◽  
Sleep Behavior ◽  
Distinctive Features ◽  
Muscle Atonia

REM sleep behavior disorder (RBD) could be a predictor of Parkinsonism even before development of typical motor symptoms. This study aims to characterize clinical features and corticomuscular and corticocortical coherence (CMC and CCC, respectively) during sleep in RBD patients with or without Parkinsonism. We enrolled a total of 105 subjects, including 20 controls, 54 iRBD, and 31 RBD+P patients, patients who were diagnosed as idiopathic RBD (iRBD) and RBD with Parkinsonism (RBD+P) in our neurology department. We analyzed muscle atonia index (MAI) and CMC between EEG and chin/limb muscle electromyography (EMG) and CCC during different sleep stages. Although differences in the CMC of iRBD group were observed only during REM sleep, MAI differences between groups were noted during both REM and NREM N2 stage sleep. During REM sleep, CMC was higher and MAI was reduced in iRBD patients compared to controls (p = 0.001, p < 0.001, respectively). Interestingly, MAI was more reduced in RBD+P compared to iRBD patients. In comparison, CCC was higher in iRBD patients compared to controls whereas CCC was lower in RBD+P groups compared to control and iRBD groups in various frequency bands during both NREM N2 and REM sleep stages. Among them, increased CMC during REM sleep revealed correlation between clinical severities of RBD symptoms. Our findings indicate that MAI, CMC, and CCC showed distinctive features in iRBD and RBD+P patients compared to controls, suggesting potential usefulness to understand possible links between these diseases.

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