REM Sleep behavior disorder and REM Sleep without atonia in patients with progressive supranuclear palsy
Identifieur interne : 003121 ( Main/Merge ); précédent : 003120; suivant : 003122REM Sleep behavior disorder and REM Sleep without atonia in patients with progressive supranuclear palsy
Auteurs : Isabelle Arnulf [France] ; Milagros Merino-Andreu [France] ; Frédéric Bloch [France] ; Eric Konofal [France] ; Marie Vidailhet [France] ; Valérie Cochen [France] ; Jean-Philippe Derenne [France] ; Yves Agid [France]Source :
- Sleep : (New York, NY) [ 0161-8105 ] ; 2005.
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- topic : Homme.
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Abstract
Study Objective: To compare sleep characteristics, rapid eye movement (REM) sleep without atonia, and REM sleep behavior disorder (RBD) in patients with progressive supranuclear palsy (tauopathy), patients with Parkinson's disease (a synucleinopathy), and control subjects. Design: Sleep interview, overnight polysomnography, and Multiple Sleep Latency Tests. Patients: Forty-five age- and sex-matched patients with probable progressive supranuclear palsy, (n = 15, aged 68 ± 8 years, 7 men), patients with Parkinson disease (n = 15), and control subjects (n = 15). Settings: Tertiary-care academic hospital. Intervention: N/A. Results: Compared to the 2 other groups, patients with progressive supranuclear palsy had a longer duration of wakefulness after sleep onset and twice as much sleep fragmentation and percentage of stage 1 sleep but had similar apnea-hypopnea indexes, periodic leg movements indexes, and mean daytime sleep latencies. REM sleep percentage was as low in patients with progressive supranuclear palsy (8% ± 6% of total sleep time) as in patients with Parkinson disease (10% ± 4%), versus 20% ± 6% in controls (analysis of variance, P <.0001). Interestingly, patients with progressive supranuclear palsy had percentages of REM sleep without atonia (chin muscle activity: 33% ± 36% of REM sleep) similar to those of patients with Parkinson disease (28% ± 35%) and dramatically higher than those of controls (0.5% ± 1%, analysis of variance, P =.008). Four (27%) patients with progressive supranuclear palsy had more than 50% REM sleep without atonia (as did a similar number of patients with Parkinson disease), and 2 of them (13%, vs 20% of patients with Parkinson disease) had clinical RBD. The four patients with progressive supranuclear palsy with excessive daytime sleepiness slept longer at night than the 11 patients with progressive supranuclear palsy who were alert (442 ± 14 minutes vs 312 ± 74 minutes, student t tests, P =.004), suggesting a primary nonnarcoleptic hypersomnia. Conclusion: REM sleep without atonia and RBD were as frequent in patients with progressive supranuclear palsy as in patients with Parkinson disease. It suggests that the downstream cause of parkinsonism, rather than its primary neuropathology (synucleinopathy vs tauopathy), is a key factor for REM sleep behavior disorder.
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Comparative study</term>
<term>Healthy subject</term>
<term>Human</term>
<term>Parkinson disease</term>
<term>Polysomnography</term>
<term>Rapid eye movement sleep</term>
<term>Supranuclear paralysis</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Paralysie susnucléaire</term>
<term>Etude comparative</term>
<term>Individu sain</term>
<term>Parkinson maladie</term>
<term>Sommeil paradoxal</term>
<term>Polysomnographie</term>
<term>Homme</term>
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<front><div type="abstract" xml:lang="en">Study Objective: To compare sleep characteristics, rapid eye movement (REM) sleep without atonia, and REM sleep behavior disorder (RBD) in patients with progressive supranuclear palsy (tauopathy), patients with Parkinson's disease (a synucleinopathy), and control subjects. Design: Sleep interview, overnight polysomnography, and Multiple Sleep Latency Tests. Patients: Forty-five age- and sex-matched patients with probable progressive supranuclear palsy, (n = 15, aged 68 ± 8 years, 7 men), patients with Parkinson disease (n = 15), and control subjects (n = 15). Settings: Tertiary-care academic hospital. Intervention: N/A. Results: Compared to the 2 other groups, patients with progressive supranuclear palsy had a longer duration of wakefulness after sleep onset and twice as much sleep fragmentation and percentage of stage 1 sleep but had similar apnea-hypopnea indexes, periodic leg movements indexes, and mean daytime sleep latencies. REM sleep percentage was as low in patients with progressive supranuclear palsy (8% ± 6% of total sleep time) as in patients with Parkinson disease (10% ± 4%), versus 20% ± 6% in controls (analysis of variance, P <.0001). Interestingly, patients with progressive supranuclear palsy had percentages of REM sleep without atonia (chin muscle activity: 33% ± 36% of REM sleep) similar to those of patients with Parkinson disease (28% ± 35%) and dramatically higher than those of controls (0.5% ± 1%, analysis of variance, P =.008). Four (27%) patients with progressive supranuclear palsy had more than 50% REM sleep without atonia (as did a similar number of patients with Parkinson disease), and 2 of them (13%, vs 20% of patients with Parkinson disease) had clinical RBD. The four patients with progressive supranuclear palsy with excessive daytime sleepiness slept longer at night than the 11 patients with progressive supranuclear palsy who were alert (442 ± 14 minutes vs 312 ± 74 minutes, student t tests, P =.004), suggesting a primary nonnarcoleptic hypersomnia. Conclusion: REM sleep without atonia and RBD were as frequent in patients with progressive supranuclear palsy as in patients with Parkinson disease. It suggests that the downstream cause of parkinsonism, rather than its primary neuropathology (synucleinopathy vs tauopathy), is a key factor for REM sleep behavior disorder.</div>
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<tree><country name="France"><noRegion><name sortKey="Arnulf, Isabelle" sort="Arnulf, Isabelle" uniqKey="Arnulf I" first="Isabelle" last="Arnulf">Isabelle Arnulf</name>
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<name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name>
<name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name>
<name sortKey="Cochen, Valerie" sort="Cochen, Valerie" uniqKey="Cochen V" first="Valérie" last="Cochen">Valérie Cochen</name>
<name sortKey="Derenne, Jean Philippe" sort="Derenne, Jean Philippe" uniqKey="Derenne J" first="Jean-Philippe" last="Derenne">Jean-Philippe Derenne</name>
<name sortKey="Konofal, Eric" sort="Konofal, Eric" uniqKey="Konofal E" first="Eric" last="Konofal">Eric Konofal</name>
<name sortKey="Merino Andreu, Milagros" sort="Merino Andreu, Milagros" uniqKey="Merino Andreu M" first="Milagros" last="Merino-Andreu">Milagros Merino-Andreu</name>
<name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name>
<name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name>
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