Behavioral manifestation profi le in idiopathic REM sleep behavior disorder


Authors: J. Nepožitek 1;  C. Ünalp 1,2;  S. Dostálová 1;  I. Příhodová 1;  V. Ibarburu Lorenzo Y Losada 1;  P. Dušek 1;  K. Šonka 1
Authors‘ workplace: Neurologická klinika a Centrum klinických, neurověd, 1. LF UK a VFN v Praze 1;  Faculty of Medicine, Ankara University, Ankara, Turkey 2
Published in: Cesk Slov Neurol N 2019; 82(4): 437-441
Category: Original Paper
doi: 10.14735/amcsnn2019437

Overview

Aim: Abnormal­ly prominent motor activity in rapid eye movement (REM) sleep is a major polysomnographic (PSG) feature of idiopathic REM sleep behavior disorder. The dia­gnosis is based on the complex nature of the movements, but more discreet motor manifestations can be seen in the video record­­ing dur­­ing PSG. The aim of this work was to perform a systematic video analysis of REM sleep movements.

Patients and methods: The motor manifestations identified in the video record­­ing of PSG in 32 patients aged 67.4 ± 7.3 years were clas­sified into four categories accord­­ing to clinical severity (elementary, exces­sive, scenic and violent). In addition, topographic distribution, brief and slow characterization of movement, as­sociation with vocalization, subsequent wakefulness and emotional subtext were determined for each motor event.

Results: An average of 114.6 ± 85.1 motor phenomena was identified. Of these, 67.8% were clas­sified as elementary, 9.1% as exces­sive, 22.3% as scenic, and 0.7% as violent. However, 31.3% of patients experienced violent manifestations. Brief movements were more frequent than slow ones (P = 0.001). Vocalization occur­red in 34.4% of patients. Movement caused wakefulness in 9.4% of patients and was at least once as­sociated with distinct emotion in 21.9%.

Conclusion: This study shows a large number of motor phenomena in REM sleep with extensive variability. Elementary events represent the vast majority. Although violent manifestations are captured in relative minority, they were detected in 31% of patients.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

REM sleep behavior disorder – motor activity – REM sleep


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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