Characterization of motor events in REM sleep behavior disorder

Bugalho, Paulo; Lampreia, Tânia; Miguel, Rita; Mendonça, Marcelo; Caetano, André; Barbosa, Raquel

doi:10.1007/s00702-017-1759-y

Cited by 16 publications

(11 citation statements)

References 9 publications

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“…This confirms previous findings by our own group using the same methodology, which had suggested a higher number of ME in patients with iRBD compared to those with PD and DLB who have RBD. 12 We may interpret these findings in a number of ways, one being that motor dysfunction or the consequences of more advanced neurodegeneration could diminish ME in PD and DLB cases (which would in turn contradict the hypothesis of motor restoration during REM sleep proposed by some studies 9,11,34 ). Another hypothesis would be a referral bias, causing more severe cases to arise from the iRBD group, as these patients would be referred to PSG mainly because of complaints directly connected with the parasomnia, whereas in other groups most patients would be referred to PSG for other complaints or in the course of disease follow-up procedures.…”

Section: Differences Related To Diagnostic Categorymentioning

confidence: 91%

“…Debate remains as to whether motor manifestations of RBD differ between patients with iRBD and RBD who fulfill criteria for an overt α-synucleinopathy such as PD, LBD and MSA (usually referred as secondary RBD, or sRBD). Although some studies have found motor events in patients with iRBD, those with PD with RBD, 9,11 and those with narcolepsy 11 to be similar, others have suggested that motor events frequency and severity could be worse in patients with iRBD than with sRBD. 12 Regarding sex predominance, epidemiological studies (some using validated questionnaires, 13 others based on the detection of REM sleep without atonia in patients with suggestive symptoms 7 ) differ from case studies, [14][15][16] showing an even percentage of female and male cases.…”

Section: Introductionmentioning

confidence: 98%

“…2,3,4 It has also become apparent that RBD could be as common in women as in men 7 and that nonviolent movements, mimicking normal daily activities, are part of the manifestation spectrum of this disease. 8 Indeed, video polysomnography (PSG) studies 9,10 show that most motor events in RBD consist of short-lived simple movements.…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Bugalho

Salavisa

2019

Journal of Clinical Sleep Medicine

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Study Objectives: To identify the interrelation and relative influence of sex, associated neurological disorder, and polysomnography (PSG) context on the manifestations of rapid eye movement (REM) sleep behavior disorder (RBD). Methods: Fifty-seven patients with RBD were assessed with video PSG regarding sleep structure, muscular activity, and motor events (ME) during REM sleep. Patients were categorized according to sex, associated neurological disorder (clinically isolated RBD [iRBD] versus RBD associated with an overt α-synucleinopathy [sRBD]) and motive for PSG (direct referral due to RBD symptoms [First, n = 14]; referred after screening procedures [Screening, n = 13]; referred during clinical follow-up for other disorders n = 22]; referred for symptoms other than RBD [Incidental, n = 8]). Results: Phasic muscular activity index and the relative number of myoclonic and trunk ME were significantly higher in males and segmental ME in female patients. sRBD was associated with Screening and iRBD with First categories. There was a higher severity of ME in patients with iRBD. Global motor severity of ME was significantly higher in the First category. In multivariate analysis, both motive for PSG and associated neurological disorder had a significant and independent influence in the global severity of ME. Conclusions: Associated neurological disorder and motive for PSG can significantly influence RBD presentation. Male sex is related with higher muscular phasic activity and a different pattern of ME, which could contribute to prevalence variations across studies. Having iRBD and being directly referred for a first consultation because of complaints compatible with RBD are interrelated and contribute independently to a higher severity of ME.

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Section: Differences Related To Diagnostic Categorymentioning

confidence: 91%

Section: Introductionmentioning

confidence: 98%

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Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Bugalho

Salavisa

2019

Journal of Clinical Sleep Medicine

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“…Whilst accounts of individuals kicking, punching, biting, or even strangling their bedpartners during sleep paint an emotive image of the condition and often capture public interest, they are prone to recall bias. More systematic studies have revealed that violent dreams and behaviors only make up a small percentage of all events (6)(7)(8). When a dream enactment is occurring, the individual's eyes will remain closed as they engage with the dream environment and their movements are generally contained to their immediate surroundings, thus differentiating these episodes from NREM parasomnias such as sleepwalking (4).…”

Section: Symptoms and Diagnostic Considerationsmentioning

confidence: 99%

A Neurologist's Guide to REM Sleep Behavior Disorder

et al. 2020

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REM Sleep Behavior Disorder (RBD) is a chronic sleep condition characterized by dream enactment and loss of REM atonia. Individuals often present to clinic with complaints of injury to themselves or their bed-partner due to violent movements during sleep. RBD patients have a high risk of developing one of the neurodegenerative α-synucleinopathy diseases: over 70% will develop parkinsonism or dementia within 12 years of their diagnosis. RBD patients also exhibit accelerated disease progression and a more severe phenotype than α-synucleinopathy sufferers without RBD. The disease's low prevalence and the relatively limited awareness of the condition amongst medical professionals makes the diagnosis and treatment of RBD challenging. Uncertainty in patient management is further exacerbated by a lack of clinical guidelines for RBD patient care. There are no binary prognostic markers for RBD disease course and there are no clinical guidelines for neurodegeneration scaling or tracking in these patients. Both clinicians and patients are therefore forced to deal with uncertain outcomes. In this review, we summarize RBD pathology and differential diagnoses, diagnostic, and treatment guidelines as well as prognostic recommendations with a look to current research in the scientific field. We aim to raise awareness and develop a framework for best practice for RBD patient management.

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“…The sample was mixed, as some patients had idiopathic RBD and others had RBD associated with Parkinson’s disease. Bugalho et al 30 found no difference in the frequency and pattern of motor events (including negative and positive emotional behaviours) during REM sleep on videopolysomnography in 14 patients with Parkinson's disease and RBD (all treated with dopaminergic drugs) vs. 18 patients with idiopathic RBD (not treated with dopaminergic drugs), suggesting that Parkinson's disease and treatment with dopaminergic agents have no major impact on the behaviours of patients with RBD. Eventually, the research was focused on the EOG correlates of emotions during REM sleep, whatever the dreaming content and its influences (previous day experiences, mood, drugs…).…”

Section: Discussionmentioning

confidence: 99%

Eye movement patterns correlate with overt emotional behaviours in rapid eye movement sleep

Maranci

Nigam

Masset

et al. 2022

Sci Rep

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Growing evidence suggests that sleep plays a key role in regulating emotions. Rapid eye movements (REMs) in REM sleep could be associated with dreams emotions, but supporting evidence is indirect. To highlight this association, we studied the REM sleep during video-polysomnography of 20 subjects with REM sleep behaviour disorder (RBD), a model of enacted dreams offering direct access to the emotional content of the sleeper (face expression, speeches, behaviour). Video and the electro-oculography recordings were divided into 3 s time intervals and classified as non-behavioural, or behavioural (neutral, positive or negative emotions), and as containing no eye movements (EMs), slow eye movements (SEMs) or REMs (isolated or bursts). Compared to the absence of EMs, neutral behaviours successively increased in the presence of SEMs (odd ratio, OR = 1.4), then isolated REMs (OR = 2.8) and then REM bursts (OR = 4.6). Positive behaviours increased with SEMs (OR = 2.8) but did not increase further with isolated REMs (OR = 2.8) and REM bursts (OR = 3). Negative behaviours were absent with SEMs, increased with isolated REMs (OR = 2.6) and further with REM bursts (OR = 10.1). These results support an association between REMs and SEMs, and dream emotions.

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Characterization of motor events in REM sleep behavior disorder

Cited by 16 publications

References 9 publications

Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

A Neurologist's Guide to REM Sleep Behavior Disorder

Eye movement patterns correlate with overt emotional behaviours in rapid eye movement sleep

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