The high frequency of periodic limb movements in patients with Lewy body dementia

Hibi, Shinichiro; Yamaguchi, Yasuhiro; Umeda‐Kameyama, Yumi; Yamamoto, Hiroshi; Iijima, Katsuya; Momose, Toshimitsu; Akishita, Masahiro; Ouchi, Yasuyoshi

doi:10.1016/j.jpsychires.2012.07.007

Cited by 23 publications

(17 citation statements)

References 28 publications

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“…For example, Rapid Eye Movement sleep behaviour disorder, severe autonomic dysfunctions, such as orthostatic hypotension, repeated syncope and systematised delusions, can be seen in patients with DLB 21. Furthermore, in a previous study, we reported a high frequency of periodic limb movements in patients with DLB 22. The results of the current study indicating that DLB patients exhibit dysrhythmic breathing compared with normal patients suggest that irregular breathing patterns may be a new clinical feature of DLB.…”

Section: Discussionsupporting

confidence: 55%

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

et al. 2013

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ObjectivesDementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD). DLB is characterised by intracytoplasmic inclusions called Lewy bodies that are often seen in the brainstem. Because modulation of the respiratory rhythm is one of the most important functions of the brainstem, patients with DLB may exhibit dysrhythmic breathing. This hypothesis has not yet been systematically studied. Therefore, we evaluated the association between DLB and dysrhythmic breathing.DesignIn this cross-sectional study consecutive inpatients who were admitted for the evaluation of progressive cognitive impairment were enrolled. We assessed breathing irregularity using polysomnographic recordings on bed rest with closed eyes, without reference to the clinical differentiation among DLB, AD and having no dementia.SettingSingle centre in Japan.Participants14 patients with DLB , 21 with AD and 12 without dementia were enrolled in this study.Primary outcome measuresThe coefficient of variation (CV) of the breath-to-breath time was calculated. We also examined the amplitude spectrum A(f) obtained using the fast Fourier transform and Shannon entropy S of A(f) in patients with DLB compared with patients with AD and patients without dementia.ResultsThe values of CV and entropy S were significantly higher in patients with DLB than in patients with AD and patients without dementia. No significant differences were observed between patients with AD and patients without dementia.ConclusionsPatients with DLB exhibit dysrhythmic breathing compared with patients with AD and patients without dementia. Dysrhythmic breathing is a new clinical feature of DLB and the spectral analysis of breathing patterns can be clinically useful for the diagnostic differentiation of DLB from AD.

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Section: Discussionsupporting

confidence: 55%

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

et al. 2013

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“…Other sleep disorders can also be observed in DLB, including PLMS. In one study comparing 9 DLB patients, 12 AD patients, and 10 nondemented patients, PLMS were significantly higher in DLB patients …”

Section: Dlbmentioning

confidence: 99%

“…In one study comparing 9 DLB patients, 12 AD patients, and 10 nondemented patients, PLMS were significantly higher in DLB patients. 86 PSP PSP, initially described by Steele et al in 1964, is characterized by supranuclear ophthalmoplegia, postural instability, parkinsonism, and pseudobulbar palsy. 87 PSP is a tauopathy resulting in marked atrophy of the midbrain.…”

Section: Other Sleep Disordersmentioning

confidence: 99%

Sleep Disorders in Atypical Parkinsonism

Abbott

Videnović

2014

Movement Disord Clin Pract

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Sleep disorders are commonly seen in atypical parkinsonism, with particular disorders occurring more frequently in specific parkinsonian disorders. Multiple systems atrophy (MSA) is a synucleinopathy often associated with nocturnal stridor which is a serious, but treatable condition highly specific to MSA. In addition, this disorder is strongly associated with rapid eye movement (REM) sleep behavior disorder (RBD), which is also seen in dementia with Lewy bodies (DLB). RBD is far less prevalent in progressive supranuclear palsy (PSP), which is a tauopathy. Insomnia and impaired sleep architecture are the most common sleep abnormalities seen in PSP. Corticobasilar degeneration (CBD) is also a tauopathy, but has far fewer sleep complaints associated with it than PSP. In this manuscript we review the spectrum of sleep dysfunction across the atypical parkinsonian disorders, emphasize the importance of evaluating for sleep disorders in patients with parkinsonian symptoms, and point to sleep characteristics that can provide diagnostic clues to the underlying parkinsonian disorder.

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“…PLMD is more commonly associated with restless leg syndrome in PD, but is also found separately in patients with DLB (Fantini et al, 2002). A study comparing patients with AD and DLB found a higher frequency of PLMD in DLB patients (Hibi et al, 2012). A lot remains unknown about PLMD, such as its etiology, true prevalence, and mechanism.…”

Section: Alpha-synuclein Aggregation Dlb and Sleepmentioning

confidence: 99%

Sleep in Alzheimer's Disease–Beyond Amyloid

Holth

Patel

Holtzman

2017

Neurobiology of Sleep and Circadian Rhythms

139

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Sleep disorders are prevalent in Alzheimer’s disease (AD) and a major cause of institutionalization. Like AD pathology, sleep abnormalities can appear years before cognitive decline and may be predictive of dementia. A bidirectional relationship between sleep and amyloid β (Aβ) has been well established with disturbed sleep and increased wakefulness leading to increased Aβ production and decreased Aβ clearance; whereas Aβ deposition is associated with increased wakefulness and sleep disturbances. Aβ fluctuates with the sleep wake cycle and is higher during wakefulness and lower during sleep. This fluctuation is lost with Aβ deposition, likely due to its sequestration into amyloid plaques. As such, Aβ is believed to play a significant role in the development of sleep disturbances in the preclinical and clinical phase of AD. In addition to Aβ, the influence of tau AD pathology is likely important to the sleep disturbances observed in AD. Abnormal tau is the earliest observable AD-like pathology in the brain with abnormal tau phosphorylation in many sleep regulating regions such as the locus coeruleus, dorsal raphe, tuberomammillary nucleus, parabrachial nucleus, and basal forebrain prior to the appearance of amyloid or cortical tau pathology. Furthermore, human tau mouse models exhibit AD-like sleep disturbances and sleep changes are very common in other tauopathies including frontotemporal dementia and progressive supranuclear palsy. Together these observations suggest that tau pathology can induce sleep disturbances and may play a large role in the sleep disruption seen in AD. To elucidate the relationship between sleep and AD it will be necessary to not only understand the role of amyloid but also tau and how these two pathologies, together with comorbid pathology such as alpha-synuclein, interact and affect sleep regulation in the brain.

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The high frequency of periodic limb movements in patients with Lewy body dementia

Cited by 23 publications

References 28 publications

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

Sleep Disorders in Atypical Parkinsonism

Sleep in Alzheimer's Disease–Beyond Amyloid

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