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REM-Schlaf-Verhaltensstörung als prodromales Stadium von α-Synukleinopathien

Klinik, Epidemiologie, Pathophysiologie, Diagnose und Behandlung

REM sleep behavior disorder as a prodromal stage of α-synucleinopathies

Symptoms, epidemiology, pathophysiology, diagnosis and therapy

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Zusammenfassung

Die REM(„rapid eye movement”)-Schlaf-Verhaltensstörung („REM sleep behavior disorder“, RBD) ist definiert als eine Parasomnie, die einerseits durch einen intermittierenden, elektromyographisch nachweisbaren Verlust der REM-Schlaf-assoziierten Atonie und andererseits durch das Auftreten ausgeprägter motorischer Aktivität während des Träumens (in der Regel mit aggressivem Inhalt) charakterisiert ist. Epidemiologische Daten über die Prävalenz von RBD sind wenig aussagekräftig. Die RBD kann idiopathisch oder symptomatisch sein. Für ihre Diagnose ist eine Video-Audio-Polysomnographie essenziell. Pharmakologisch stehen für ihre Behandlung hauptsächlich Clonazepam und Melatonin zur Verfügung. Aktuelle Studien belegen, dass Betroffene mit einer idiopathischen RBD ein auf bis zu 80 % erhöhtes spezifisches Risiko haben, in 10 bis 20 Jahren eine neurodegenerative Erkrankung vom α-Synukleinopathie-Typ (Parkinson-Krankheit, Demenz vom Lewy-Körper-Typ, Multisystematrophie) zu entwickeln. Die vorliegende Arbeit liefert eine kurze Übersicht über die Klinik, Epidemiologie, Pathophysiologie, Diagnose und Therapie der RBD.

Summary

Rapid eye movement (REM) sleep behavior disorder (RBD) is defined as a parasomnia characterized by loss of REM sleep-associated atonia and the presence of motor activity during dreaming typically presenting with an aggressive dream content. Epidemiological data on the prevalence of RBD are insufficient but it can be idiopathic or symptomatic. A video-audio polysomnography is essential for diagnosis. Clonazepam and melatonin are available as pharmaceutical treatment. Recent studies demonstrated that individuals suffering from idiopathic RBD carry a high specific risk (up to 80 %) for developing a neurodegenerative disorder of the α-synucleinopathy type (e.g. Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy) within 10–20 years. The current article provides a short overview of symptoms, epidemiology, pathophysiology, diagnosis and therapy of RBD.

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Literatur

  1. Anderson KN, Shneerson JM (2009) Drug treatment of REM sleep behavior disorder: the use of drug therapies other than clonazepam. J Clin Sleep Med 5:235–239

    PubMed  Google Scholar 

  2. Bertrand JA, Bedetti C, Postuma RB et al (2012) Color discrimination deficits in Parkinson’s disease are related to cognitive impairment and white-matter alterations. Mov Disord 27:1781–1788

    Article  PubMed  Google Scholar 

  3. Bjørnarå KA, Dietrichs E, Toft M (2013) REM sleep behavior disorder in Parkinson’s disease – is there a gender difference? Parkinsonism Relat Disord 19:120–122

    Article  PubMed  Google Scholar 

  4. Bodkin CL, Schenck CH (2009) Rapid eye movement sleep behavior disorder in women: relevance to general and specialty medical practice. J Womens Health (Larchmt) 18:1955–1963

    Article  Google Scholar 

  5. Boeve BF, Silber MH, Ferman TJ (2003) Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med 4:281–284

    Article  PubMed  Google Scholar 

  6. Boeve BF, Silber MH, Saper CB et al (2007) Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease. Brain 130:2770–2788

    Article  CAS  PubMed  Google Scholar 

  7. Boeve BF (2010) REM sleep behavior disorder: updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions. Ann N Y Acad Sci 1184:15–54

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Boot BP, Boeve BF, Roberts RO et al (2012) Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: a population-based study. Ann Neurol 71:49–56

    Article  PubMed Central  PubMed  Google Scholar 

  9. Braak H, Del Tredici K, Rüb U et al (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24:197–211

    Article  PubMed  Google Scholar 

  10. Cicolin A, Lopiano L, Zibetti M et al (2004) Effects of deep brain stimulation of the subthalamic nucleus on sleep architecture in parkinsonian patients. Sleep Med 5:207–210

    Article  PubMed  Google Scholar 

  11. Claassen DO, Josephs KA, Ahlskog JE et al (2010) REM sleep behavior disorder preceding other aspects of synucleinopathies by up to half a century. Neurology 75:494–499

    Article  CAS  PubMed  Google Scholar 

  12. Dauvilliers Y, Jennum P, Plazzi G (2013) Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy. Sleep Med 14:775–781

    Article  PubMed  Google Scholar 

  13. Dauvilliers Y, Postuma RB, Ferini-Strambi L et al (2013) Family history of idiopathic REM behavior disorder: a multicenter case-control study. Neurology 80:2233–2235

    Article  PubMed  Google Scholar 

  14. Frauscher B, Iranzo A, Gaig C et al (2012) Normative EMG values during REM sleep for the diagnosis of REM sleep behaviour disorder. Sleep 35:835–847

    PubMed  Google Scholar 

  15. Gagnon JF, Bédard MA, Fantini ML et al (2002) REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology 59:585–589

    Article  CAS  PubMed  Google Scholar 

  16. Gagnon JF, Postuma RB, Montplaisir J (2006) Update on the pharmacology of REM sleep behavior disorder. Neurology 67:742–747

    Article  PubMed  Google Scholar 

  17. Gagnon JF, Vendette M, Postuma RB et al (2009) Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson’s disease. Ann Neurol 66:39–47

    Article  PubMed  Google Scholar 

  18. Hernán MA, Takkouche B, Caamaño-Isorna F, Gestal-Otero JJ (2002) A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson’s disease. Ann Neurol 52:276–284

    Article  PubMed  Google Scholar 

  19. Iranzo A, Aparicio J (2009) A lesson from anatomy: focal brain lesions causing REM sleep behavior disorder. Sleep Med 10:9–12

    Article  PubMed  Google Scholar 

  20. Iranzo A, Lomeña F, Stockner H et al (2010) Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study [corrected]. Lancet Neurol 9:1070–1077

    Article  CAS  PubMed  Google Scholar 

  21. Iranzo A, Tolosa E, Gelpi E et al (2013) Neurodegenerative disease status and post-mortem pathology in idiopathic rapid-eye-movement sleep behaviour disorder: an observational cohort study. Lancet Neurol 12:443–445

    Article  PubMed  Google Scholar 

  22. Jouvet M, Jeannerod M, Delorme F (1965) Organization of the system responsible for phase activity during paradoxal sleep. C R Seances Soc Biol Fil 159:1599–1604

    CAS  PubMed  Google Scholar 

  23. Ju YE, Larson-Prior L, Duntley S (2011) Changing demographics in REM sleep behavior disorder: possible effect of autoimmunity and antidepressants. Sleep Med 12:278–283

    Article  PubMed  Google Scholar 

  24. Kashihara K, Imamura T, Shinya T (2010) Cardiac 123I-MIBG uptake is reduced more markedly in patients with REM sleep behavior disorder than in those with early stage Parkinson’s disease. Parkinsonism Relat Disord 16:252–255

    Article  PubMed  Google Scholar 

  25. Kotagal V, Albin RL, Müller ML et al (2012) Symptoms of rapid eye movement sleep behavior disorder are associated with cholinergic denervation in Parkinson disease. Ann Neurol 71:560–568

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Krenzer M, Anaclet C, Vetrivelan R et al (2011) Brainstem and spinal cord circuitry regulating REM sleep and muscle atonia. PLoS One 6:e24998

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Kunz D, Mahlberg R (2010) A two-part, double-blind, placebo-controlled trial of exogenous melatonin in REM sleep behaviour disorder. J Sleep Res 19:591–596

    Article  PubMed  Google Scholar 

  28. Lai BC, Marion SA, Teschke K, Tsui JK (2002) Occupational and environmental risk factors for Parkinson’s disease. Parkinsonism Relat Disord 8:297–309

    Article  CAS  PubMed  Google Scholar 

  29. Luppi PH, Clément O, Sapin E et al (2011) The neuronal network responsible for paradoxical sleep and its dysfunctions causing narcolepsy and rapid eye movement (REM) behavior disorder. Sleep Med Rev 15:153–163

    Article  PubMed  Google Scholar 

  30. Mahowald MW, Schenck CH, Bornemann MA (2007) Pathophysiologic mechanisms in REM sleep behavior disorder. Curr Neurol Neurosci Rep 7:167–172

    Article  PubMed  Google Scholar 

  31. Nomura T, Inoue Y, Högl B et al (2011) Comparison of the clinical features of rapid eye movement sleep behavior disorder in patients with Parkinson’s disease and multiple system atrophy. Psychiatry Clin Neurosci 65:264–271

    Article  PubMed  Google Scholar 

  32. Oertel WH, Vadasz D, Ries V et al (2013) Prodromale Marker der Parkinson-Krankheit. Akt Neurol 40:452–461

    Article  Google Scholar 

  33. Ohayon MM, Schenck CH (2010) Violent behavior during sleep: prevalence, comorbidity and consequences. Sleep Med 11:941–946

    Article  PubMed Central  PubMed  Google Scholar 

  34. Oudiette D, Leu-Semenescu S, Roze E et al (2012) A motor signature of REM sleep behavior disorder. Mov Disord 27:428–431

    Article  PubMed  Google Scholar 

  35. Poryazova R, Oberholzer M, Baumann CR, Bassetti CL (2013) REM sleep behavior disorder in Parkinson’sdisease: a questionnaire-based survey. J Clin Sleep Med 9:55–59

    PubMed  Google Scholar 

  36. Postuma RB, Lang AE, Massicotte-Marquez J, Montplaisir J (2006) Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 66:845–851

    Article  CAS  PubMed  Google Scholar 

  37. Postuma RB, Gagnon JF, Vendette M et al (2008) REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features. J Neurol Neurosurg Psychiatry 79:1117–1121

    Article  CAS  PubMed  Google Scholar 

  38. Postuma RB, Gagnon JF, Vendette M et al (2009) Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology 72:1296–1300

    CAS  PubMed  Google Scholar 

  39. Postuma RB, Gagnon JF, Vendette M, Montplaisir JY (2009) Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and Parkinson’s disease. Brain 132:3298–3307

    Article  CAS  PubMed  Google Scholar 

  40. Postuma RB, Gagnon JF, Rompré S, Montplaisir JY (2010) Severity of REM atonia loss in idiopathic REM sleep behavior disorder predicts Parkinson disease. Neurology 74:239–244

    Article  CAS  PubMed  Google Scholar 

  41. Postuma RB, Lanfranchi PA, Blais H et al (2010) Cardiac autonomic dysfunction in idiopathic REM sleep behavior disorder. Mov Disord 25:2304–2310

    Article  PubMed  Google Scholar 

  42. Postuma RB, Gagnon JF, Vendette M et al (2011) Olfaction and color vision identify impending neurodegeneration in rapid eye movement sleep behavior disorder. Ann Neurol 69:811–818

    Article  PubMed  Google Scholar 

  43. Postuma RB, Montplaisir J, Lanfranchi P et al (2011) Cardiac autonomic denervation in Parkinson’s disease is linked to REM sleep behavior disorder. Mov Disord 26:1529–1533

    Article  PubMed  Google Scholar 

  44. Postuma RB, Montplaisir JY, Pelletier A et al (2012) Environmental risk factors for REM sleep behavior disorder: a multicenter case-control study. Neurology 79:428–434

    Article  CAS  PubMed  Google Scholar 

  45. Ringman JM, Simmons JH (2000) Treatment of REM sleep behavior disorder with donepezil: a report of three cases. Neurology 55:870–871

    Article  CAS  PubMed  Google Scholar 

  46. Romenets SR, Gagnon JF, Latreille V et al (2012) Rapid eye movement sleep behavior disorder and subtypes of Parkinson’s disease. Mov Disord 27:996–1003

    Article  PubMed  Google Scholar 

  47. Sasai T, Matsuura M, Inoue Y (2013) Factors associated with the effect of pramipexole on symptoms of idiopathic REM sleep behavior disorder. Parkinsonism Relat Disord 19:153–157

    Article  PubMed  Google Scholar 

  48. Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW (1986) Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep 9:293–308

    CAS  PubMed  Google Scholar 

  49. Schenck CH, Mahowald MW (1990) A PSG, neurologic, psychiatric and clinical outcome report on 70 consecutive cases with REM Sleep Behavior Disorder (RBD): sustained clonazepam efficacy in 89.5 % of 57 treated patients. Clev Clin J Med 57:10–24

    Article  Google Scholar 

  50. Schenck CH, Mahowald MW (1996) Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med 100:333–337

    Article  CAS  PubMed  Google Scholar 

  51. Schenck CH, Mahowald MW (2005) Rapid eye movement sleep parasomnias. Neurol Clin 23:1107–1126

    Article  PubMed  Google Scholar 

  52. Schenck CH, Boeve BF, Mahowald MW (2013) Delayed emergence of a parkinsonian disorder or dementia in 81 % of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: a 16-year update on a previously reported series. Sleep Med 14:744–748

    Article  PubMed  Google Scholar 

  53. Schenck CH, Montplaisir JY, Frauscher B et al (2013) Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy – a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group. Sleep Med 14:795–806

    Article  CAS  PubMed  Google Scholar 

  54. Sixel-Döring F, Traumann E, Mollenhauer B, Trenkwalder C (2011) Associated factors for REM sleep behavior disorder in Parkinson’s disease. Neurology 77:1048–1054

    Article  PubMed  Google Scholar 

  55. Stiasny-Kolster K, Doerr Y, Moeller JC et al (2005) Combination of ‚idiopathic‘ REM sleep behaviour disorder and olfactory dysfunction as possible indicator for α-synucleinopathy demonstrated by dopamine transporter FP-CIT-SPECT. Brain 128:126–137

    Article  CAS  PubMed  Google Scholar 

  56. Stiasny-Kolster K, Mayer G, Schäfer S et al (2007) The REM sleep behavior disorder screening questionnaire – a new diagnostic instrument. Mov Disord 22:2386–2393

    Article  PubMed  Google Scholar 

  57. Unger MM, Belke M, Menzler K et al (2010) Diffusion tensor imaging in idiopathic REM sleep behavior disorder reveals microstructural changes in the brainstem, substantia nigra, olfactory region, and other brain regions. Sleep 33:767–773

    PubMed  Google Scholar 

  58. Vetrivelan R, Fuller PM, Tong Q, Lu J (2009) Medullary circuitry regulating rapid eye movement sleep and motor atonia. J Neurosci 29:9361–9369

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  59. Vyas U, Franco R (2012) REM sleep behavior disorder as an early marker for development of neurodegenerative diseases. BJMP 5:a506

    Google Scholar 

  60. Wing YK, Lam SP, Li SX et al (2008) REM sleep behaviour disorder in Hong Kong Chinese: clinical outcome and gender comparison. J Neurol Neurosurg Psychiatry 79:1415–1416

    Article  CAS  PubMed  Google Scholar 

  61. Winkelman JW, James L (2004) Serotonergic antidepressants are associated with REM sleep without atonia. Sleep 27:317–321

    PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. W.H. Oertel, C. Depboylu, M. Krenzer, D. Vadasz, V. Ries, F. Sixel-Döring und G. Mayer: keine Angaben

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Authors and Affiliations

  1. Klinik für Neurologie, Philipps-Universität, Baldingerstr., 35043, Marburg, Deutschland

    W.H. Oertel, C. Depboylu, M. Krenzer, D. Vadasz, V. Ries & G. Mayer

  2. Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Paracelsus-Elena-Klinik, Kassel, Deutschland

    F. Sixel-Döring

  3. Klinik für Neurologie, Hephata-Klinik, Schwalmstadt-Treysa, Deutschland

    G. Mayer

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  1. W.H. Oertel
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  2. C. Depboylu
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  4. D. Vadasz
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  5. V. Ries
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  6. F. Sixel-Döring
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  7. G. Mayer
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Correspondence to W.H. Oertel.

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Oertel, W., Depboylu, C., Krenzer, M. et al. REM-Schlaf-Verhaltensstörung als prodromales Stadium von α-Synukleinopathien. Nervenarzt 85, 19–25 (2014). https://doi.org/10.1007/s00115-013-3891-8

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