Comparison of REM sleep behaviour disorder variables between patients with progressive supranuclear palsy and those with Parkinson’s disease

Nomura, Takashi; Inoue, Yuichi; Takigawa, Hiroshi; Nakashima, Kenichiro

doi:10.1016/j.parkreldis.2011.10.018

Cited by 48 publications

(25 citation statements)

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“…Diverse etiologies include cases of tauopathy related parkinsonian syndromes (Progressive supranuclear palsy, Guadaloupean parkinsonism) [149][150][151], TDP43opathies (frontotemporal dementia, amyotrophic lateral sclerosis) [7,152], amyloidopathies (Alzheimer's disease) [7,153]. RBD has also been associated with some trinucleatide repeat disorders including spinal cerebellar ataxia type 3 (SCA3) [154][155][156][157] and Huntington's disease [158].…”

Section: Non-synuclein Neurodegenerative Etiologiesmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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Parasomnias are abnormal behaviors emanating from or associated with sleep. Sleepwalking and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, or promote sleep inertia lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after an arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications; in particular, the widely prescribed benzodiazepine receptor agonists. Recently, compelling evidence suggests that nocturnal eating may in some cases be a nonmotor manifestation of Restless Legs Syndrome (RLS). rapid eye movement (REM) Sleep Behavior Disorder (RBD) is characterized by a loss of REM paralysis leading to potentially injurious dream enactment. The loss of atonia in RBD often predates the development of Parkinson's disease and other disorders of synuclein pathology. Parasomnia behaviors are related to an activation (in NREM parasomnias) or a disinhibition (in RBD) of central pattern generators (CPGs). Initial management should focus on decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders. Clonazepam and melatonin appear to be effective therapies in RBD, whereas paroxetine has been reported effective in some cases of sleep terrors. At this point, pharmacotherapy for other parasomnias is less certain, and further investigations are necessary.Keywords Parasomnia . Sleepwalking . Sleep terrors . REM sleep behavior disorder . Restless legs syndrome Classification of ParasomniasParasomnias are typically classified by the sleep state from which they arise: non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM) (see Table 1 NREM parasomnias include: confusional arousals, sleepwalking disorder, and sleep terrors. These behaviors arise when the cortex incompletely arouses from deep NREM sleep, often due to comorbid conditions that provoke repeated arousal or promote sleep inertia. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking and related disorders [3].Sleep-related eating disorder (SRED) is currently classified in the International Classification of Sleep Disorders, 2nd edition (ICSD-2) under "Other Parasomnia" [1]. However the vast majority of SRED cases emanate from NREM [4], and the complex amnestic behaviors with ambulation are striking similar to sleepwalking [5]. Furthermore, both SRED and sleepwalking are frequently triggered by sedating agents in the setting of underlying motor restlessness [6]. Thus, considering these similarities, SRED will be reviewed immediately after NREM parasomnias.REM sleep behavior disorder is the most clinically relevant REM parasomnia. The loss of atoni...

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Section: Non-synuclein Neurodegenerative Etiologiesmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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“…Among the neurodegenerative disorders, RBD is typically associated with synucleinopathies and is less associated with PSP [28]. In previous research, REM sleep without atonia and RBD occurred in 5-40% of those with PSP [2, 4, 5]. Therefore, though the likelihood of sleep movement disorders are increased in PSP, it is unlikely that they are the sole reason for the disrupted CAR in this study.…”

Section: Discussionmentioning

confidence: 62%

“…Specifically, using overnight polysomnography (PSG), individuals with PSP were found to take longer to fall asleep [2], spent less time asleep [3-5], and more time awake after initial sleep onset [5]. Summary measures found increased sleep fragmentation [5] and decreased sleep efficiency [3, 4]. Though these studies reported only a single night of recording, the type of sleep disruption reported, if chronically present, would likely disrupt circadian activity rhythms.…”

Section: Introductionmentioning

confidence: 99%

Rest-activity rhythm disruption in progressive supranuclear palsy

et al. 2016

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Objective/Background The brainstem is among the first regions affected in Progressive Supranuclear Palsy (PSP) and is part of the sleep/circadian regulation network. In two small studies, blood pressure and core body temperature circadian patterns were disrupted in PSP, however it is unclear if circadian activity rhythms are also affected. Our objective was to perform circadian analyses of the rest-activity rhythms in PSP and determine the association with increasing disease severity. Patients/Methods Individuals with a clinical PSP diagnosis (n=17; 9 men) and healthy older adults (n=17; 9 men) were recruited for this study. Participants wore actigraphy wristbands and completed sleep diaries for up to 14 consecutive days. Data were analyzed to assess circadian activity strength (amplitude, mesor, f-ratio), phase (acrophase), and circadian stability (intradaily variability, interdaily stability, relative amplitude). Analyses controlled for sleep fragmentation, cognition and self-reported depression. The association between disease severity using the PSP rating scale and circadian activity rhythm disruption was assessed. Results Individuals with PSP had significantly smaller circadian activity mesor (p≤0.001), amplitude (p≤0.001), robustness (f-ratio, p<0.01), relative amplitude (p≤ 0.001) and interdaily stability (p≤0.01), with increased intradaily variability (p<0.05). CAR remained weaker in PSP after controlling for sleep fragmentation, and again when also controlling for cognitive impairment and depression. Weaker circadian activity (mesor, amplitude, f-ratio, and relative amplitude) was associated with increased disease severity. Conclusions Circadian activity rhythms are disrupted in individuals with PSP as compared to controls, and worsen with disease severity. This is the first study to describe circadian activity rhythms in PSP.

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“…En bloc turning, similar to PD, and en bloc sitting -but without any relief from levodopa therapies (Boeve, 2012) -differentiates PSPS from PD. Although both PSPS and PD can have sleep disturbances, the nature of these disturbances may differ (Nomura et al, 2012). For example, REM sleep behaviour disorder is uncommon in PSPS but common in PD.…”

Section: Progressive Supranuclear Palsy Syndromementioning

confidence: 99%

Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy

Bruns

Josephs

2013

International Review of Psychiatry

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Corticobasal syndrome (CBS) and progressive supranuclear palsy syndrome (PSPS) are two of the atypical Parkinsonism syndromes, in that patients exhibit rigidity, occasional tremor and postural instability, but do not symptomatically respond to dopamine replacement. CBS and PSPS can often present with complex cognitive difficulties and neuropsychiatric disturbances. Symptoms of depression, apathy, or agitation can be subtle and are often overlooked as reactions to learning a new diagnosis of Parkinsonism. These symptoms may be the earliest presenting evidence of CBS or PSPS, and these syndromes can be misdiagnosed with a primary psychiatric disorder rather than a neurodegenerative condition. Patients may be inappropriately treated with antipsychotic medications that exacerbate the extra-pyramidal motor features of the syndromes. When symptoms are considered to comprise a neurodegenerative syndrome, it may be an inaccurate diagnosis as many features of CBS and PSPS not only overlap with each other, but also with other dementia syndromes. This review discusses similarities and differences between the syndromes of CBS and PSPS in terms of neuropsychiatric features. Improved characterization of the clinical syndromes is necessary to better predict underlying pathology. Improved education about these diseases would help patients, caregivers and clinicians to anticipate symptom progression and avoid premature nursing home placement.

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Comparison of REM sleep behaviour disorder variables between patients with progressive supranuclear palsy and those with Parkinson’s disease

Cited by 48 publications

References 9 publications

Parasomnias: An Updated Review

Parasomnias: An Updated Review

Rest-activity rhythm disruption in progressive supranuclear palsy

Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy

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