Video analysis of motor events in REM sleep behavior disorder

Abstract

In REM sleep behavior disorder (RBD), several studies focused on electromyographic characterization of motor activity, whereas video analysis has remained more general. The aim of this study was to undertake a detailed and systematic video analysis. Nine polysomnographic records from 5 Parkinson patients with RBD were analyzed and compared with sex- and age-matched controls. Each motor event in the video during REM sleep was classified according to duration, type of movement, and topographical distribution. In RBD, a mean of 54 +/- 23.2 events/10 minutes of REM sleep (total 1392) were identified and visually analyzed. Seventy-five percent of all motor events lasted <2 seconds. Of these events, 1,155 (83.0%) were classified as elementary, 188 (13.5%) as complex behaviors, 50 (3.6%) as violent, and 146 (10.5%) as vocalizations. In the control group, 3.6 +/- 2.3 events/10 minutes (total 264) of predominantly elementary simple character (n = 240, 90.9%) were identified. Number and types of motor events differed significantly between patients and controls (P < 0.05). This study shows a very high number and great variety of motor events during REM sleep in symptomatic RBD. However, most motor events are minor, and violent episodes represent only a small fraction.

REM-Schlaf-Verhaltensstörung (RBD)

“…Unsere Gruppe beschäftigte sich in den letzten zehn Jahren auch mit Videoklassifikation von motorischen Ereignissen bei Patienten mit RBD [22][23][24]. Dabei konnten wir zeigen, dass selbst bei Patienten mit schwerer RBD die Mehrzahl der motorischen Ereignisse "sehr kleine elementare Bewegungen" sind.…”

“…Die Videoanalysemethoden rangierten von rein deskriptiv bis zu einer Schwere-Klassification [20] Die erste uns bekannte Studie zum Thema stammt jedoch von Emilia Sforza bereits aus dem Jahr 1988 [21]. Unsere Gruppe beschäftigte sich in den letzten zehn Jahren auch mit Videoklassifikation von motorischen Ereignissen bei Patienten mit RBD [22][23][24]. Dabei konnten wir zeigen, dass selbst bei Patienten mit schwerer RBD die Mehrzahl der motorischen Ereignisse "sehr kleine elementare Bewegungen" sind.…”

Perchance to dream? Primordial motor activity patterns in vertebrates from fish to mammals: their prenatal origin, postnatal persistence during sleep, and pathological reemergence during REM sleep behavior disorder

“…However, in RBD In support of a major thesis in this paper that ontogenetically and phylogenetically early neuromotor activity patterns during RBM and REM sleep can resurface in stereotypical or quasi-stereotypical fashion with simple movements and complex behaviors found with human RBD, the following study on "a motor signature of REM sleep behavior disorder" will be described [88] . This study sought to determine if there was a common pattern in movements during RBD across three RBD clinical subgroups: idiopathic sleep") has also been observed in studies using detailed video analysis of REM sleep behaviors in human RBD [89,90] .…”

“…Also, in the two studies just cited [89,90] , there were a very large number also in dogs and cats [27] . Furthermore, early developmental sleep neuromotor dysregulation may also predispose to the later emergence of a spectrum of other abnormal dissociated sleep-wake motor-behavioral states emerging as parasomnias, apart from RBD [91,92] .…”

REM-Schlafverhaltensstörung – Status quo der diagnostischen Methoden und Bedeutung der Diagnose im Zusammenhang mit neurodegenerativen Erkrankungen

“…Verschiedene visuelle Klassifikationssysteme charakterisieren die RBD anhand der synchronisierten Videoaufzeichnung als einfache oder komplexe Bewegungen [8,9], als milde, mittelschwere oder schwere Manifestation [10], stützen sich auf qualitative Beschreibungen [11] oder benutzen detaillierte Analysen von Anzahl und Art der motorischen Ereignisse während des REM-Schlafs [12]. Diese Methoden sind entweder sehr zeitraubend oder interpretationsabhängig, zudem nicht operationalisierbar und somit für vergleichende Studien nicht geeignet.…”