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01-08-2019 | Antidepressant Drugs | Psychiatry and Preclinical Psychiatric Studies - Original Article

Clinical profiles of late-onset psychiatric patients exhibiting incidental REM sleep without atonia

Authors: Hiroshige Fujishiro, Masato Okuda, Kunihiro Iwamoto, Seiko Miyata, Youta Torii, Shuji Iritani, Norio Ozaki

Published in: Journal of Neural Transmission | Issue 8/2019

Abstract

Rapid eye movement (REM) sleep without atonia (RWA), which is a hallmark of REM sleep behavior disorder (RBD) on polysomnography (PSG), may represent specific characteristics of prodromal Parkinson’s disease (PD)/dementia with Lewy bodies (DLB), even when dream-enactment behavior is absent. We investigated the clinical profiles associated with PD/DLB in late-onset psychiatric patients exhibiting incidental RWA. Among patients who underwent PSG in our psychiatric ward, eight with incidental RWA, nine with idiopathic RBD, and seven with PD or DLB who had preceding RBD were included. Clinical variables, including the percentage of RWA in the total REM sleep (%RWA), were compared among the three groups. The frequency of depressive disorders as a primary psychiatric diagnosis and antidepressant usage were significantly higher in the incidental RWA group than in the other groups. There were no differences in the prevalence of supportive features of DLB among the three groups. The median %RWA was significantly lower in the incidental RWA group than in the other groups. Although the cardiac ¹²³I-metaiodobenzylguanidine uptake was significantly higher in the incidental RWA group compared with the other groups, the groups showed overlap in the specific binding ratios on dopamine transporter imaging. All patients in the three groups exhibited cingulate island sign ratios on brain perfusion single-photon emission computed tomography within a threshold of 0.281, which is the optimal cut-off value for a diagnosis of DLB. In this series, late-onset psychiatric patients with incidental RWA partially shared common clinical profiles with idiopathic RBD and PD/DLB.

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Title: Clinical profiles of late-onset psychiatric patients exhibiting incidental REM sleep without atonia
Authors: Hiroshige Fujishiro
Masato Okuda
Kunihiro Iwamoto
Seiko Miyata
Youta Torii
Shuji Iritani
Norio Ozaki
Publication date: 01-08-2019
Publisher: Springer Vienna
Keywords: Antidepressant Drugs
Affective Disorder
Dementia
Affective Disorder
Polysomnography
Parkinson's Disease
Dementia
Antidepressant Drugs
Published in: Journal of Neural Transmission / Issue 8/2019
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-019-02035-7

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Clinical profiles of late-onset psychiatric patients exhibiting incidental REM sleep without atonia

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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