A discrete pontine ischemic lesion could cause REM sleep behavior disorder

Kimura, Kohji; Tachibana, Naoko; Kohyama, Jun; Otsuka, Yoritaka; Fukazawa, Seiji; Waki, Riichiro

doi:10.1212/wnl.55.6.894

Cited by 138 publications

(53 citation statements)

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“…RBD has been associated with several etiologies, including medications, autoimmune/limbic encephalitis, narcolepsy, structural lesions in the brainstem, and neurodegenerative disease [1,2,9,10,11]. The few cases which have been studied with magnetic resonance imaging (MRI) have shown lesions in the dorsal pons [10,11], yet the specific neuronal networks involved in human RBD pathogenesis have not been identified with certainty.…”

Section: Discussionmentioning

confidence: 99%

“…The few cases which have been studied with magnetic resonance imaging (MRI) have shown lesions in the dorsal pons [10,11], yet the specific neuronal networks involved in human RBD pathogenesis have not been identified with certainty. Although ubiquitin and α-synuclein immunocytochemistry were not used in the case reported by Uchiyama et al [4], and the consensus criteria for the clinical and pathologic diagnoses of dementia with Lewy bodies (DLB) and LBD had not yet been published, the distribution of LBs suggests that their case would now be classified as brainstem-predominant LBD [6,7].…”

Section: Discussionmentioning

confidence: 99%

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Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease

et al. 2007

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Background and purpose-Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia reflecting changes in the brain, but which specific neuronal networks are involved in human RBD pathogenesis has not yet been determined. To date, only one case of idiopathic RBD has undergone autopsy, in which "incidental Lewy body disease" was found. Due to the severe neuronal loss and gliosis in the substantia nigra (SN) and locus ceruleus (LC) in this case, degeneration of brainstem monoaminergic neurons was postulated as the underlying substrate for RBD. Additional cases of idiopathic RBD with neuropathologic examination may help clarify which key brainstem structures are involved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease

et al. 2007

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“…[9][10][11]26 For example, in a study including 119 stroke Chinese patients, 11% had RBD and presence of RBD was significantly associated with brainstem infarcts and smaller infarct volumes. 26 In another multicenter case-control study including 318 idiopathic RBD cases and 318 matched controls (181 sleep disorder controls and 137 healthy volunteers), RBD cases reported more cardiovascular disease (odds ratio [OR] 1.6; 95% CI 1.0-2.5) relative to the controls, and the association became stronger when 181 sleep disorder controls were removed (OR 2.4; 95% CI 1.3-4.6).…”

Section: Insomniamentioning

confidence: 99%

“…8 Some case reports suggested that stroke may cause RBD. [9][10][11] In a previous cross-sectional study, we also found that individuals with probable RBD (pRBD) had higher odds of several concurrent stroke risk factors, such as diabetes and hyperlipidemia. 12 However, whether RBD predicts subsequent stroke risk remains unknown to date.…”

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confidence: 99%

Probable REM sleep behavior disorder and risk of stroke

Pavlova

Liu

et al. 2017

Neurology

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Objective: To examine whether probable REM sleep behavior disorder (pRBD) was associated with increased risk of developing stroke in a community-based cohort. Methods:The study included 12,003 participants (mean age 54.0 years) of the Kailuan Study, free of stroke, cancer, Parkinson disease, dementia, and head injury at baseline (2012). We determined pRBD using a validated REM sleep behavior disorder (RBD) questionnaire in 2012. Incident stroke cases were confirmed by review of medical records. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke according to pRBD status, adjusting for several sleep measures (i.e., insomnia, daytime sleepiness, sleep duration, snoring, and use of hypnotics) and other potential confounders.Results: During 3 years of follow-up, we documented 159 incident stroke cases. Relative to participants without pRBD at the baseline, those with pRBD had a 157% higher risk (95% CI 59%-313%) of developing stroke. Presence of pRBD was associated with increased risk of both stroke types-the adjusted HR was 1.93 (95% CI 1.07-3.46) for ischemic stroke and 6.61 (95% CI 2.27-19.27) for hemorrhagic stroke.Conclusions: Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association. Neurology ® 2017;88:1849-1855 GLOSSARY AIS 5 Athens Insomnia Scale; BMI 5 body mass index; CI 5 confidence interval; ESS 5 Epworth Sleepiness Scale; HDL-C 5 high-density lipoprotein cholesterol; HR 5 hazard ratio; ICD-10 5 International Classification of Diseases-10; LDL-C 5 lowdensity lipoprotein cholesterol; OR 5 odds ratio; OSA 5 obstructive sleep apnea; PD 5 Parkinson disease; pRBD 5 probable REM sleep behavior disorder; RBD 5 REM sleep behavior disorder; RBDQ-HK 5 RBD questionnaire-Hong Kong; RMB 5 renminbi.REM sleep behavior disorder (RBD) is associated with synucleinopathies, and a large proportion of individuals with RBD may already have or later develop Parkinson disease (PD), dementia with Lewy bodies, or multiple system atrophy. [1][2][3] Synucleinopathies were often associated with symptoms of autonomic dysfunction, such as impaired blood pressure control and reduced heart rate variability. 4,5 Consistently, individuals with idiopathic RBD experienced worse autonomic function, including cardiovascular, gastrointestinal, and urinary domains, relative to control participants. 6,7 The autonomic nervous system may have a role in the prepathologic state or contribute to the precipitating factors of the acute phase of stroke, such as atherosclerosis and sympathetic hyperactivity. 8 Some case reports suggested that stroke may cause RBD. 9-11 In a previous cross-sectional study, we also found that individuals with probable RBD (pRBD) had higher odds of several concurrent stroke risk factors, such as diabetes and hyperlipidemia. 12 However, whether RBD predicts subsequ...

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“…In typical cases, patients with RBD have a lesion in the dorsolateral mesopontine tegmentum (Culebras and Moore, 1989;Kimura et al, 2000). The amount of sleep and the cycles of the sleep stages from non-REM sleep to REM sleep are normal.…”

Section: -2 Pathophysiology Of Rbdmentioning

confidence: 99%

Neurobiological basis of state-dependent control of motor behaviors

Takakusaki

Saitoh

Nonaka³

et al. 2006

Sleep and Biological Rhythms

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We note the importance of an appropriate combination of excitability for the higher (neocortex, basal ganglia, and limbic system) and lower (brainstem-spinal cord) motor systems could be necessary for normal behavior during wakefulness and REM sleep.Neurotransmitters such as acetylcholine, the monoamines, GABA, and the orexins, would regulate the background excitability of the higher and lower motor systems so that an interaction of these systems could be appropriately maintained. Pathophysiological mechanisms of sleep deficiency may be induced by not only an organic disturbance of brain structures (hardware) but also by dysfunction of the neurotransmitter systems (software). From these considerations, we provide a hypothetical model for "state-dependent interaction of the higher and lower motor systems" for understanding normal behavior and pathophysiological mechanisms of sleep-related disorders such as narcolepsy and the REM-sleep behavioral syndrome.2

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A discrete pontine ischemic lesion could cause REM sleep behavior disorder

Cited by 138 publications

References 5 publications

Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease

Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease

Probable REM sleep behavior disorder and risk of stroke

Neurobiological basis of state-dependent control of motor behaviors

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