Polysomnographic diagnosis of idiopathic REM sleep behavior disorder

Montplaisir, Jacques; Gagnon, Jean‐François; Fantini, María Livia; Postuma, Ronald B.; Dauvilliers, Yves; Désautels, Alex; Rompré, Sylvie; Paquet, Jean

doi:10.1002/mds.23257

Cited by 265 publications

(209 citation statements)

References 23 publications

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“…For example, previous studies have revealed that RBD patients exhibit normal atonia and lack of phasic activity on mentalis recordings but have increased phasic activity in the upper limbs. 35 As we did not record data from the upper extremities, we were not able to capture this phasic activity. In future studies, detailed EMG recordings could be used in patients with suspected RBD.…”

Section: Discussionmentioning

confidence: 99%

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Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Barut

Taşçılar

Varo

2015

Journal of Clinical Sleep Medicine

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are prone to error. Importantly, the study performed by Gerbin recommended a combination of sleep diaries and polysomnography be used in future studies to investigate sleep problems in patients with ET. 6 The aim of our study was to evaluate sleep disturbances and sleep-related events in patients with ET, PD, and controls, using both self-assessment tools and polysomnographic readings. METHODS Study SampleThe ethics committee of Bülent Ecevit University approved this prospective study, and informed consent was obtained from all participants. Between 2010 and 2012, 21 patients with PD who fulfi lled the Parkinson Disease Society Bank criteria, 9 and 16 patients with ET who fulfi lled Movement Disorders BRIEF SUMMARY Current Knowledge/Study Rationale: Sleep problems in ET and PD patients had been investigated in few studies by using subjective assessment tools like self-report questionnaires previously. This study was conducted to evaluate and to compare sleep problems in these two common movement disorders by using PSG which is an objective assessment tool. Study Impact: This study will improve the knowledge about sleep problems in ET and PD patients. Furthermore this is the fi rst study comparing sleep problems in ET and PD patients using PSG.Objective: Sleep problems are a common non-motor complication of Parkinson disease (PD), and patients with essential tremor (ET) share a number of motor and non-motor features of PD. To clarify the relationship between these disorders, we evaluated the sleep problems in patients with ET and PD using assessment scales and objective polysomnographic (PSG) testing. Method: Twenty-one consecutive patients with PD, 16 with ET, and 14 healthy subjects participated in this study and were compared in terms of sleep related complaints, fi nal sleep related diagnosis, and polysomnographic features. Results:The results of our study have shown that patients with PD were more likely than were those with ET to have a history of REM sleep behavior disorders (RBD) (p = 0.001) and excessive daytime sleepiness (p ≤ 0.05). Additionally, PSG data revealed that ET patients had lower mean SpO 2 values (p ≤ 0.05) and REM without atonia (RWA) (p = 0.032) than did patients with PD. Conclusion: This is the fi rst study to use PSG to evaluate sleep problems both in ET and PD patients. The results point out different sleep problems in these two common movement disorders which should be investigated in further studies. Keywords: essential tremor, Parkinson disease, sleep, REM behavior disorder (RBD), REM without atonia (RWA) Citation: Barut BO, Tascilar N, Varo A. Sleep disturbances in essential tremor and Parkinson disease: a polysomnographic study.

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Section: Discussionmentioning

confidence: 99%

“…Thus we did not capture upper extremity EMG data, as is now recommended in possible RBD patients. 35 Despite these limitations, the results may be helpful in designing further studies to differentiate sleep problems in ET and PD.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Barut

Taşçılar

Varo

2015

Journal of Clinical Sleep Medicine

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“…Polysomnographic diagnosis of RBD and RWA was performed along international recommendations [11]: We used following references values: a 30-second epoch was scored as tonic if chin EMG activity was present for more than 50% of the epoch; phasic epochs were scored in response of 2-second mini-epochs (within 30-second REM sleep epoch) with bursts of EMG activity; RWA was ascertained if tonic chin EMG density was greater than approximately 30% and / or a phasic chin EMG density was greater than approximately 15% of total REM sleep time was assessed as REM sleep without atonia (RWA). RWA with complex movements or vocalization as assessed by time-locked video was defined as manifest RBD.…”

Section: Methodsmentioning

confidence: 99%

Revisiting the impact of REM sleep behavior disorder on motor progression in Parkinson's disease

Sommerauer¹,

Valko²,

Werth³

et al. 2014

Parkinsonism & Related Disorders

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BACKGROUND Estimation of progression in Parkinson's disease (PD) is useful to guide clinical decisions and to enable patients to plan and manage their life with PD. Rapid eye movement (REM) sleep behavior disorder (RBD) and REM sleep without atonia (RWA) are recognized as early harbingers of neurodegeneration and may precede motor symptoms by years. However, their impact on motor progression remains elusive. METHODS We retrospectively analyzed polysomnographic and clinical data of 59 PD patients, grouping them into patients with RBD (n = 15), RWA (n = 22) and those with normal muscle atonia (n = 22). We compared the three groups with regard to motor progression, defined as changes in Unified Parkinson's Disease Rating Scale (UPDRS) III values per year, and selected PD specific characteristics. RESULTS Motor disability at first visit and time interval between first and last visits were similar between groups. We observed a significantly faster motor progression in PD patients with RBD and RWA than in those with preserved REM sleep atonia. CONCLUSION Our findings suggest that impaired muscle atonia during REM sleep might represent a marker of faster motor progression in PD.

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“…1 The PSG criteria of RBD was according to a published method. 13,14 Patients were allowed to be prescribed levodopa (except controlled-release levodopa or > 5 daily doses of immediate-release levodopa), anticholinergic agents, entacapone, monoamine oxidase-B inhibitors or amantadine, provided that doses were stable for ≥ 28 days prior to baseline assessment and stable during the trial. Exclusion criteria were dementia, hallucinations, psychosis, current or previous treatment with other dopamine agonists, or antidopaminergic agents.…”

Section: Subjectsmentioning

confidence: 99%

“…VPSG staging and scoring followed the American Academy of Sleep Medicine (AASM) guidelines, 16 with the exception that REM sleep stage was scored based only on electroencephalogram and electoroculograms 14 to account for the frequent of occurrence of REM sleep without atonia (RWA) in PD. During REM sleep, we calculated the REM density, the phasic and tonic electromyographic activity in the submentalis muscle, 17 and the percentage of REM sleep with abnormal behaviors, 7 as previously reported.…”

Section: Nocturnal Video-polysomnographymentioning

confidence: 99%

Effects of Rotigotine on REM Sleep Behavior Disorder in Parkinson Disease

Wang

Yang

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: REM sleep behavior disorder (RBD) is a common manifestation of Parkinson disease (PD). In this study, we assessed the effects of rotigotine transdermal patch on RBD features in patients with PD. Methods:In this prospective open-label study, eleven PD patients with untreated RBD were administered rotigotine patches for up to seven months to ameliorate their parkinsonism. The severities of their RBD symptoms before and after rotigotine therapy were evaluated through patient and bed partner interviews, a validated evaluation scale (REM sleep behavior disorder questionnaire-Hong Kong, RBDQ-HK), and blinded assessments based on videopolysomnographic (VPSG) measure. Results: Rotigotine improved parkinsonism and subjective sleep quality in PD patients with RBD. The RBDQ-HK total score, especially the Factor 2 score, was decreased, which demonstrated that the subjective severity of RBD symptoms was improved after rotigotine treatment, especially the frequency and severity of abnormal RBD-related motor behaviors. The VPSG analyses showed that the total sleep time (TST) and stage 1% were increased and that the PLMS index was decreased. However, no differences in the RBD-related sleep measures were observed. Conclusions: The improved RBD symptoms and VPSG measures of PD patients in this study (TST, stage 1%, and PLMS index) suggest that, in PD, rotigotine may partially improve RBD-related symptoms. Rotigotine should be considered to be an optional drug for the treatment of RBD symptoms in PD.

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Polysomnographic diagnosis of idiopathic REM sleep behavior disorder

Cited by 265 publications

References 23 publications

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Revisiting the impact of REM sleep behavior disorder on motor progression in Parkinson's disease

Effects of Rotigotine on REM Sleep Behavior Disorder in Parkinson Disease

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