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Title
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Polysomnographic phenotype of isolated REM sleep without atonia
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Author
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Abstract
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| Objective: Isolated REM sleep without atonia (iRSWA) is regarded as a prodromal phase of REM sleep behavior disorder and synucleinopathies. In iRSWA patients, we investigated the polysomnographic characteristics that are known to be altered in (prodromal) Parkinson's disease (PD): periodic limb movements of sleep [PLMS] (increased), REM density (reduced), and heart rate variability [HRV] (reduced). Methods: We compared video-polysomnographic studies of 49 iRSWA subjects with 41 controls. RSWA and PLMS were scored visually. REM density (REM/hour) and HRV were calculated automatically. Results: We found a higher median total (15.90 vs 7.20; p = 0.001), REM (21.80 vs 11.0; p < 0.001) and non-REM (11.75 vs 5.72; p = 0.027) PLMS index, and a higher mean REM density (342.45 vs 275.96; p = 0.010) in the iRSWA group, with a significant positive correlation between RSWA severity and these variables (r = 0.39; p < 0.00, r = 0.48; p < 0.001, r = 0.24; p = 0.021, r = 0.28; p = 0.012). We found no significant difference in HRV between groups. Conclusions: Our results suggest an association between RWSA and REM density and PLMS, but not HRV. The positive correlation between these variabilities may imply overlapping pathophysiological processes. Significance: The evidence of higher REM density and normal HRV weakens the hypothesis that iRWSA is a prodromal PD stage. An alternative interpretation is, however, that REM density and HRV change during caudal-rostral neurodegeneration. |
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Language
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English
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Source (journal)
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Clinical neurophysiology. - Amsterdam
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Publication
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Amsterdam
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2020
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ISSN
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1388-2457
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DOI
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10.1016/J.CLINPH.2020.07.005
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Volume/pages
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131
:10
(2020)
, p. 2508-2515
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ISI
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000570011700025
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Pubmed ID
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32773210
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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