scholarly journals Trauma Immediately Preceding REM-Behavior Disorder: A Valuable Prognostic Marker?

2021 ◽  
Vol 12 ◽  
Author(s):  
Stevie R. Williams ◽  
Nelly Henzler ◽  
Pavla Peřinová ◽  
Ian A. Morrison ◽  
Jason G. Ellis ◽  
...  
Keyword(s):  
Eye Movement ◽  
Symptom Onset ◽  
Neurodegenerative Disorder ◽  
Behavior Disorder ◽  
Traumatic Experience ◽  
Hospital Visit ◽  
Sleep Behavior ◽  
Trauma History ◽  
History Of

Background: The definition of rapid eye movement (REM) sleep behavior disorder (RBD) has varied over the years. Rapid eye movement sleep behavior disorder can be considered isolated or idiopathic or can occur in the context of other disorders, including trauma-associated sleep disorder (TSD) and overlap parasomnia. However, whether trauma in RBD carries any prognostic specificity is currently unknown.Study Objectives: To test the hypothesis that RBD secondary to trauma is less likely to result in the development of neurodegeneration compared to idiopathic RBD (iRBD) without trauma in the general population.Methods: A retrospective cohort study of 122 consecutive RBD patients (103 males) at two tertiary sleep clinics in Europe between 2005 and 2020 was studied. Patients were diagnosed as having iRBD by video polysomnography (vPSG) and had a semi-structured interview at presentation, including specifically eliciting any history of trauma. Patients with secondary RBD to recognized causes were excluded from the study. Patients with iRBD were categorized into three groups according to reported trauma history: (1) No history of trauma, (2) traumatic experience at least 12 months prior to RBD symptom onset, and (3) traumatic experience within 12 months of RBD symptom onset. Idiopathic RBD duration was defined as the interval between estimated onset of RBD symptoms and last hospital visit or death. Follow-up duration was defined as the interval between iRBD diagnosis and last hospital visit or death.Results: In a follow-up period of up to 18 years, no patient who experienced trauma within 12 months preceding their iRBD diagnosis received a diagnosis of a neurodegenerative disorder (n = 35), whereas 38% of patients without trauma within the 12 months of symptom onset developed a neurodegenerative illness. These patients were also significantly more likely to have a family history of α-synucleinopathy or tauopathy.Conclusions: The development of RBD within 12 months of experiencing a traumatic life event, indistinguishable clinically from iRBD, did not lead to phenoconversion to a neurodegenerative disorder even after 18 years (mean follow up 6 years). We suggest that a sub-type of RBD be established and classified as secondary RBD due to trauma. Additionally, we advocate that a thorough psychological and trauma history be undertaken in all patients presenting with dream enactment behaviors (DEB).

scholarly journals Lost in a Dream

2019 ◽  
pp. 381-396
Author(s):  
Carlos L. Rodriguez ◽  
Babak Tousi
Keyword(s):  
Motor Neurons ◽  
Neurodegenerative Disorders ◽  
Dementia With Lewy Bodies ◽  
Neurodegenerative Disorder ◽  
Lewy Bodies ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
The Relationship ◽  
Over Time

Rapid-eye-movement sleep behavior disorder (RBD) is a parasomnia that is closely associated with neurodegenerative disorders. RBD is usually caused by neurodegeneration within the brainstem that disables the system responsible for immobilizing skeletal muscles during REM sleep and thus permits motor neurons to activate these muscles during dreaming. The underlying source of the brainstem neurodegeneration spreads over time to other central nervous system regions until it has sufficiently evolved to permit clinical recognition of the underlying neurodegenerative disorder. Longitudinal follow-up of patients with RBD has demonstrated that most patients subsequently develop some neurodegenerative disorder years later, particularly the synucleinopathies. We review the relationship between RBD and dementia with Lewy bodies, which is one of the synucleinopathies. The management of RBD is reviewed with discussion of the relevant considerations in patients with dementia with Lewy bodies.

Arousal Characteristics in Patients with Parkinson’s Disease and Isolated Rapid Eye Movement Sleep Behavior Disorder

SLEEP ◽  
2021 ◽  
Author(s):  
Andreas Brink-Kjær ◽  
Matteo Cesari ◽  
Friederike Sixel-Döring ◽  
Brit Mollenhauer ◽  
Claudia Trenkwalder ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Eye Movement ◽  
Rem Sleep ◽  
Regression Models ◽  
Muscle Tone ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Rapid Eye Movement ◽  
Sleep Behavior

Abstract Study objectives Patients diagnosed with isolated rapid eye movement (REM) sleep behavior disorder (iRBD) and Parkinson’s disease (PD) have altered sleep stability reflecting neurodegeneration in brainstem structures. We hypothesize that neurodegeneration alters the expression of cortical arousals in sleep. Methods We analyzed polysomnography data recorded from 88 healthy controls (HC), 22 iRBD patients, 82 de novo PD patients without RBD and 32 with RBD (PD+RBD). These patients were also investigated at a 2-year follow-up. Arousals were analyzed using a previously validated automatic system, which used a central EEG lead, electrooculography, and chin electromyography. Multiple linear regression models were fitted to compare group differences at baseline and change to follow-up for arousal index (ArI), shifts in electroencephalographic signals associated with arousals, and arousal chin muscle tone. The regression models were adjusted for known covariates affecting the nature of arousal. Results In comparison to HC, patients with iRBD and PD+RBD showed increased ArI during REM sleep and their arousals showed a significantly lower shift in α-band power at arousals and a higher muscle tone during arousals. In comparison to HC, the PD patients were characterized by a decreased ArI in NREM sleep at baseline. ArI during NREM sleep decreased further at the 2-year follow-up, although not significantly Conclusions Patients with PD and iRBD present with abnormal arousal characteristics as scored by an automated method. These abnormalities are likely to be caused by neurodegeneration of the reticular activation system due to alpha-synuclein aggregation.

scholarly journals Long-Term Follow-up Investigation of Isolated Rapid Eye Movement Sleep Without Atonia Without Rapid Eye Movement Sleep Behavior Disorder: A Pilot Study

2015 ◽  
Vol 11 (11) ◽  
pp. 1273-1279 ◽  
Author(s):  
Ambra Stefani ◽  
David Gabelia ◽  
Birgit Högl ◽  
Thomas Mitterling ◽  
Philipp Mahlknecht ◽  
...  
Keyword(s):  
Pilot Study ◽  
Eye Movement ◽  
Behavior Disorder ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Sleep Behavior ◽  
Long Term Follow Up

scholarly journals Validation of the REM sleep behavior disorder screening questionnaire in the Czech population

2019 ◽  
Author(s):  
Jitka Bušková ◽  
Pavla Peřinová ◽  
Eva Miletínová ◽  
Petr Dušek ◽  
Evžen Růžička ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Eye Movement ◽  
Neurodegenerative Disorder ◽  
Behavior Disorder ◽  
Screening Tools ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Sleep Behavior ◽  
Screening Questionnaire ◽  
Obstructive Sleep

Abstract Background: Idiopathic rapid eye movement sleep behavior disorder (iRBD) affects 1 – 2% of people over 60 years of age and presents a high risk of developing a neurodegenerative disorder from the group of synucleinopathies, such as Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy. Therefore, screening tools are needed. In 2007, the rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ) was developed and has been translated into several languages. The aim of study was to assess the validity and reliability of the Czech version of the RBD-SQ in a mixed population of sleep clinic patients, supplemented by healthy volunteers and RBD patients. Methods: Participants included 81 iRBD patients, 205 patients with other sleep disorders (obstructive sleep apnea, insomnia, restless legs syndrome and periodic limb movement disorder, other parasomnias, or central hypersomnias including narcolepsy) and 20 healthy volunteers. ¨ Results: The mean RBD-SQ score in the iRBD patients was 9.4 ± 2.8 points, and in the non-RBD group it was 4.5 ± 3.0 (P < 0.0001). Receiver -operator analysis yielded an area under the curve of 0.864, suggesting good diagnostic performance of the scale. When using a cut-off value for positivity of 5 points, sensitivity was 0.89 and specificity was 0.62. Conclusions: The Czech version of the RBD-SQ is a sensitive tool for screening for iRBD patients and helps to identify subjects for complete clinical workup.

scholarly journals Actigraphic Screening for Rapid Eye Movement Sleep Behavior Disorder

2019 ◽  
Author(s):  
Šandala Kristián ◽  
Dostálová Simona ◽  
Nepožitek Jiří ◽  
Ibarburu Lorenzo y Losada Veronika ◽  
Dušek Petr ◽  
...  
Keyword(s):  
Motor Activity ◽  
Eye Movement ◽  
Neurodegenerative Disorder ◽  
Behavior Disorder ◽  
Sleep Fragmentation ◽  
Dominant Hand ◽  
Healthy Controls ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Sleep Behavior

AbstractBackgroundThe patients suffering of the rapid eye movement sleep behavior disorder (RBD) are in high risk of developing a neurodegenerative disorder, most frequently from the group of alpha-synucleinopathies, such as Parkinson’s disease (PD), Dementia with Lewy Bodies (DLB) or multiple system atrophy (MSA). The definitive diagnosis of RBD is based on polysomnographic investigation. Actigraphy is much easier to perform and reflects condition in patient’s home environment.The aimsThe aim of this study was to find suitable biomarkers for RBD, which can be detectable by actigraphic recording.MethodsHigh resolution actigraphic recording (MotionWatch, CamNtech ltd.) and confirming polysomnographic recording was performed on 45 RBD patients, 30 patients with other sleep-related motor disorders and 20 healthy controls. Each individual file was analysed by software testing for amount of sleep (MotionWare 1.1.20) and secondly for periodic motor activity (PLMS analysis 1.0.16). The 13-item patient self-rating RBD screening questionnaire (RBD-SQ) translated to Czech language was also used for screening purposes. We used an RBD-SQ score of five points as a positive test result, as suggested by the original publication of the scale.ResultsWhen using the actigraphic sleep detection, we encountered significant differences mostly on non-dominant hand, related to sleep fragmentation - most notably increased percentage of Short immobile bouts (47.0% vs. 28.0%, p<0.0001), increased Fragmentation index (72.5 vs. 40.7, p<0.0001) and decreased percentage of Sleep efficiency (72.1% vs. 86.8%, p<0.0001)in RBD subjects compared to other sleep disorders and controls. When analyzing periodic motor activity, we also found surprisingly more periodic hand movements (p=0.028, corrected for multiple testing), but differences on lower extremities using either measurement were not significant. The discrimination function based on RBD-SQ and Short immobile bouts % could allocate correctly the RBD status in 87.6% of cases with Wilks Lambda 0.435 and p<0.0001.ConclusionIn our single-center study in patients from the Czech population, we found that actigraphic recording from upper extremities shows consistently more prominent sleep fragmentation in RBD patients compared to other sleep diagnoses or healthy controls. Actigraphy may be useful in broader screening for RBD.

A prospective, naturalistic follow-up study of treatment outcomes with clonazepam in rapid eye movement sleep behavior disorder

2016 ◽  
Vol 21 ◽  
pp. 114-120 ◽  
Author(s):  
Shirley Xin Li ◽  
Siu Ping Lam ◽  
Jihui Zhang ◽  
Mandy Wai Man Yu ◽  
Joey Wing Yin Chan ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Eye Movement ◽  
Behavior Disorder ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Sleep Behavior ◽  
Follow Up Study
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