Details

Autor(en) / Beteiligte

• Nepozitek, Jiri
• Unalp, Canan
• Dostalova, Simona
• Dusek, Petr
• Kemlink, David
• Prihodova, Iva
• Ibarburu Lorenzo y Losada, Veronika
• Trnka, Jiri
• Zogala, David
• Bezdicek, Ondrej
• Nikolai, Tomas
• Perinova, Pavla
• Dall'Antonia, Irene
• Ruzicka, Evzen
• Sonka, Karel

Titel

Systematic video-analysis of motor events during REM sleep in idiopathic REM sleep behavior disorder, follow-up and DAT-SPECT

Ist Teil von

• Sleep medicine, 2021-07, Vol.83, p.132-144

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2021

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Abnormal motor manifestations in REM sleep are the most visible feature of idiopathic REM sleep behavior disorder (iRBD), which precedes the overt alpha-synucleinopathy. The aim of this study was to perform a systematic visual analysis of the motor events (ME) captured during video-polysomnography, and clarify their relation to the disease severity. Thirty-four iRBD patients (5 women, 29 men; age 67.7 ± 7.2) with a mean follow-up duration 2.9 ± 1.1 years. and 33 controls (10 women, 23 men; age 61.5 ± 8.2) were examined. The ME captured during REM sleep were classified into four categories, previously defined by Frauscher et al. according to clinical severity: minor/simple jerks, major, complex and violent. An average frequency of 110.8 ± 75.2 ME per hour were identified in iRBD, 7.5 ± 11.6 in the controls (p < 0.001). Of these ME, 68.4% were classified as minor/simple jerks, 9.3% as major, 21.7% as complex and 0.7% as violent. The ME frequency was negatively associated with tracer binding on dopamine transporter single-photon emission computed tomography (DAT-SPECT); the association was stronger for caudate nucleus compared to putamen. During follow-up seven patients (24.1%) phenoconverted, yielding a yearly phenoconversion rate 8.3%. Violent ME were associated with increased hazard ratio for phenoconversion in frequency (p = 0.012) and total duration (p = 0.007). Patients with higher amounts of violent ME had a greater risk of phenoconversion; therefore, their role as a predictor should be considered. Additionally, ME were associated with nigrostriatal degeneration, according to DAT-SPECT. These findings indicate that the degree of the clinical severity of motor manifestations in iRBD reflects the severity of the disease. •Violent motor events mark impending conversion of iRBD to overt alpha-synucleinopathy.•Motor events are associated with nigrostriatal degeneration according to DAT-SPECT.•Violent motor events occur sporadically compared to frequent non-violent, mostly simple jerks.