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.

scholarly journals Reduced striatal vesicular monoamine transporter 2 in REM sleep behavior disorder: imaging prodromal parkinsonism

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Leah C. Beauchamp ◽  
Victor L. Villemagne ◽  
David I. Finkelstein ◽  
Vincent Doré ◽  
Ashley I. Bush ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Time Window ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Vesicular Monoamine Transporter ◽  
Motor Symptoms ◽  
Monoamine Transporter ◽  
Sleep Behavior ◽  
Nigrostriatal Degeneration ◽  
Non Motor Symptoms

Abstract Motor deficits in parkinsonism are caused by degeneration of dopaminergic nigral neurons. The success of disease-modifying therapies relies on early detection of the underlying pathological process, leading to early interventions in the disease phenotype. Healthy (n = 16), REM sleep behavior disorder (RBD) (n = 14), dementia with Lewy bodies (n = 10), and Parkinson’s disease (PD) (n = 20) participants underwent 18F-AV133 vesicular monoamine transporter type-2 (VMAT2) PET to determine the integrity of the nigrostriatal pathway. Clinical, neurophysiological and neuropsychological testing was conducted to assess parkinsonian symptoms. There was reduced VMAT2 levels in RBD participants in the caudate and putamen, indicating nigrostriatal degeneration. RBD patients also presented with hyposmia and anxiety, non-motor symptoms associated with parkinsonism. 18F-AV133 VMAT2 PET allows identification of underlying nigrostriatal degeneration in RBD patients. These findings align with observations of concurrent non-motor symptoms in PD and RBD participants of the Parkinson’s Progression Markers Initiative. Together, these findings suggest that RBD subjects have prodromal parkinsonism supporting the concept of conducting neuroprotective therapeutic trials in RBD-enriched cohorts. Ongoing longitudinal follow-up of these subjects will allow us to determine the time-window of clinical progression.

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 Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Petr Dušek ◽  
Veronika Lorenzo y Losada Ibarburu ◽  
Ondrej Bezdicek ◽  
Irene Dall’antonia ◽  
Simona Dostálová ◽  
...  
Keyword(s):  
Dopamine Transporter ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Motor Symptoms ◽  
Sleep Behavior ◽  
Binding Ratio ◽  
Dat Spect ◽  
Non Motor Symptoms

Abstract The aim of this study was to evaluate associations of motor and non-motor symptoms with dopamine transporter binding in prodromal stage of synucleinopathies. We examined 74 patients with idiopathic REM sleep behavior disorder (RBD), which is a prodromal synucleinopathy, and 39 controls using Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment, University of Pennsylvania Smell Identification Test (UPSIT), Farnsworth-Munsell 100 hue test, orthostatic test, Scales for Outcomes in PD-Autonomic, Beck depression inventory-II, State-Trait Anxiety Inventory, and video-polysomnography. Electromyographic muscle activity during REM sleep was quantified according to Sleep Innsbruck-Barcelona criteria. In 65 patients, dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging was performed, putaminal binding ratio was calculated and scans were classified as normal, borderline, or abnormal. Compared to controls, RBD patients had significantly more severe scores in all examined tests. Patients with abnormal DAT-SPECT had higher MDS-UPDRS motor score (p = 0.006) and higher prevalence of orthostatic hypotension (p = 0.008). Putaminal binding ratio was positively associated with UPSIT score (p = 0.03) and negatively associated with tonic (p = 0.003) and phasic (p = 0.01) muscle activity during REM sleep. These associations likely reflect simultaneous advancement of underlying pathology in substantia nigra and susceptible brainstem and olfactory nuclei in prodromal synucleinopathy.

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.

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.

scholarly journals Sleep apnea and REM sleep behavior disorder in patients with Chiari malformations

2008 ◽  
Vol 66 (2b) ◽  
pp. 344-349 ◽  
Author(s):  
Paulo Sérgio A. Henriques-Filho ◽  
Riccardo Pratesi
Keyword(s):  
Sleep Apnea ◽  
Brain Stem ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Stages ◽  
Type I ◽  
Sleep Behavior ◽  
Abnormal Movements ◽  
Chiari Malformations

BACKGROUND: Chiari malformations (CM) may result in the appearance of REM sleep behavior disorder (RBD) and sleep apnea syndrome (SAS) that can be considered markers of brain stem dysfunction. PURPOSE: To evaluate the frequency of RBD and SAS in patients with CM type I and II. METHOD: Were evaluated 103 patients with CM by means of full night polysomnography. Were scoring different sleep stages, frequency of abnormal movements (through video monitoring) and abnormal respiratory events. RESULTS: Of the 103 patients, 36 showed CM type I and 67 CM type II. Episodes of RBD were observed in 23 patients. Abnormal apnea-hypopnea index (AHI) was observed in 65 patients. CONCLUSION: The high rate of RBD suggests that this parassomnia and the increased frequency of central sleep apnea episodes, may be considered as a marker of progressive brain stem dysfunction.

scholarly journals Validation of Visually Identified Muscle Potentials during Human Sleep Using High Frequency/Low Frequency Spectral Power Ratios

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 55
Author(s):  
Mo H. Modarres ◽  
Jonathan E. Elliott ◽  
Kristianna B. Weymann ◽  
Dennis Pleshakov ◽  
Donald L. Bliwise ◽  
...  
Keyword(s):  
Rem Sleep ◽  
High Frequency ◽  
Spectral Power ◽  
Low Frequency ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Emg Activity ◽  
Sleep Stages ◽  
Sleep Behavior ◽  
Human Sleep

Surface electromyography (EMG), typically recorded from muscle groups such as the mentalis (chin/mentum) and anterior tibialis (lower leg/crus), is often performed in human subjects undergoing overnight polysomnography. Such signals have great importance, not only in aiding in the definitions of normal sleep stages, but also in defining certain disease states with abnormal EMG activity during rapid eye movement (REM) sleep, e.g., REM sleep behavior disorder and parkinsonism. Gold standard approaches to evaluation of such EMG signals in the clinical realm are typically qualitative, and therefore burdensome and subject to individual interpretation. We originally developed a digitized, signal processing method using the ratio of high frequency to low frequency spectral power and validated this method against expert human scorer interpretation of transient muscle activation of the EMG signal. Herein, we further refine and validate our initial approach, applying this to EMG activity across 1,618,842 s of polysomnography recorded REM sleep acquired from 461 human participants. These data demonstrate a significant association between visual interpretation and the spectrally processed signals, indicating a highly accurate approach to detecting and quantifying abnormally high levels of EMG activity during REM sleep. Accordingly, our automated approach to EMG quantification during human sleep recording is practical, feasible, and may provide a much-needed clinical tool for the screening of REM sleep behavior disorder and parkinsonism.

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