Study on rapid eye movement sleep behavior disorder in patients with Parkinson's disease at early stage

Abstract

Objective To investigate the incidence, occurrence time and electrophysiological characteristics of rapid eye movement behavior disorder (RBD) in patients with early Parkinson's disease (PD), and the characteristics of motor symptoms and non . motor symtoms (NMS). Methods Sixty PD patients were divided into PD + RBD group (N = 42) and control group (N = 18) according to whether they were complicated with RBD or not. Unified Parkinson's Disease Rating Scale (UPDRS)Ⅱ andⅢ, Hoehn-Yahr Stage, Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), RBD Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS) and polysomnography (PSG) were used in 60 patients.  Results Among 60 patients, 42 (70% ) were accompanied by RBD. PSG showed that PD + RBD patients mainly presented upper limb stretching and gripping, body twitching, laughing, shouting, cursing and other non.violent actions, except 2 cases presented violent actions, such as hitting, kicking, etc. In PD + RBD group, the age was older (P = 0.024), duration was longer (P = 0.000), and UPDRSⅡ (P = 0.005)，UPDRSⅢ(P = 0.001), the scale values of Hoehn-Yahr Sotage 2 (P = 0.007), anxiety (P = 0.044) and depression (P = 0.001) ratio were all higher than control group. There were significant differences in density of mandible myoelectric activity (P = 0.000) and ratio of rapid eye movement (REM) without atonia (P = 0.000) between 2 groups. In PD + RBD group, 16 patients (38.10% ) had symptoms of RBD, earlier than PD occurred 5.20 (3.91, 6.51) years.  Conclusions PD patients with older age, longer duration, more severe motor symptoms and non?motor symptoms were more likely to be accompanied by RBD. The severity of RBD in PD patients accompanied with RBD is higher than that in PD without RBD. RBD may be the early manifestation of PD. PSG has important value in the diagnosis of PD with RBD.

DOI: 10.3969/j.issn.1672-6731.2017.10.006