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Olfactory dysfunction in patients with Parkinson's disease complicated REM sleep behavior disorder
S118
Abstracts/Sleep Medicine 16 (2015) S2–S199
2
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Denmark 3 H. Lundbeck A/S, Denmark 4 Center for Healthy Aging, University of Copenhagen, Denmark
Introduction: Patients with idiopathic REM sleep behavior disorder (iRBD) are at high risk of developing Parkinson’s disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/ NREM transitions. Materials and methods: We determined the frequency of wake/ sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 36 patients with PD (52–78 years, 12F/24M), 31 patients with iRBD (45–76 years, 5F/26M), 25 patients with periodic leg movement (PLM) (37–77 years, 12F/13M) and 23 controls (40–73 years, 16F/ 7M). Measures were computed based on automatic data-driven labeled sleep staging. Results: Patients with PD showed significantly lower REM sleep stability than controls and patients with PLM and iRBD. Patients with PD also had significantly lower NREM sleep stability and significantly more transitions between REM and NREM sleep than controls, but not compared with patients with iRBD or PLM. Patients with iRBD had significantly lower REM sleep stability compared with patients with PLM and controls. Conclusion: We conclude that W, NREM and REM sleep stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease. Acknowledgements: The PhD project is supported by grants from H. Lundbeck A/S, the Lundbeck Foundation, the Technical University of Denmark and the Center for Healthy Aging, University of Copenhagen. http://dx.doi.org/10.1016/j.sleep.2015.02.1422
Olfactory dysfunction in patients with Parkinson’s disease complicated REM sleep behavior disorder T. Nomura 1, Y. Inoue 2, M. Kishi 1, K. Nakashima 1 1 Tottori University, Japan 2 Tokyo Medical University
Introduction: Olfactory dysfunction and REM sleep behavior disorder (RBD) frequently occurred in patients with Parkinson’s disease (PD). These symptoms were paid attention to not only premotor symptoms of PD but also risk factor to dementia in PD. We evaluated the association between these symptoms in PD. Materials and methods: Thirty eight patients with PD were examined olfactory examination (Odor Stick Identification Test for Japanese: OSIT-J) and polysomnogram (PSG). We divided these patients into PD with clinical RBD, PD with subclinical RBD, and PD with normal REM sleep. These three groups were compared on the proportion of subjective olfactory dysfunction, each category of OSIT-J, and total scores of OSIT-J by chi square test and a one-way analysis of variance. Results: Nineteen were categorized as PD with clinical RBD, 7 as PD with subclinical RBD, and 12 as PD with normal REM sleep. There were no significant differences of clinical backgrounds. However, PD with clinical RBD had more patients with subjective olfactory dysfunction than the other groups . There were significant difference of total OSIT-J score among three groups (PD with clinical RBD: 3.4 ± 2.3,
PD with subclinical RBD: 4.6 ± 2.0, PD with normal REM sleep: 6.2 ± 3.1, p = 0.014). A post hoc test revealed that PD group with clinical RBD had significant lower than that with normal REM sleep (p = 0.011). PD patients with normal REM sleep had more patients with correct of rose, gas, and perfume than those with clinical RBD. Conclusion: Olfactory dysfunction was associated with RBD findings. Both these symptoms were important for premotor symptoms and development of risk in patients with PD. http://dx.doi.org/10.1016/j.sleep.2015.02.1423
Increased motor activity during REM sleep is linked with dopamine-function in idiopathic REM sleep behaviour disorder and Parkinson’s disease M. Zoetmulder 1,2, M. Nikolic 3, H. Biernat 2, L. Korbo 2, L. Friberg 4, P. Jennum 5 1 Danish Center for Sleep Medicine, Glostrup Hospital, Denmark 2 Department of Neurology, Bispebjerg Hospital, Denmark 3 Department of Clinical Neurophysiology, Glostrup Hospital, Denmark 4 Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Denmark 5 Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Denmark
Introduction: Idiopathic rapid eye movement sleep behavior disorder (iRBD) is characterized by impaired motor inhibition and dream-enacting behavior during REM sleep. Longitudinal studies have shown that iRBD-patients have increased risk of developing an α-synucleinopathy. We investigated the relationship between the nigrostriatal-dopamine-system and muscle activity during sleep in iRBD and Parkinson’s. Materials and methods: Ten iRBD patients, 10 PD patients with PD, 10 PD patients without RBD, and 10 healthy controls were included and assessed with 123I-FP-CIT SPECT, neurological examination, and polysomnography. Results: IRBD patients and PD patients with RBD had increased phasic EMG-activity compared with healthy controls. 123I-FP-CIT uptake in the putamen-region was highest in controls, followed by iRBD patients, and lowest in PD patients. In iRBD patients EMGactivity in the mentalis muscle was correlated to 123I-FP-CIT uptake in the putamen. In PD patients EMG-activity was correlated to antiParkinson medication. Conclusion: Our results support the hypothesis that increased EMG-activity during REM sleep is at least partly linked to the nigrostriatal dopamine system in iRBD, and with dopaminergic medication in PD. Acknowledgements: This work was supported by the Lundbeck Foundation, the National Foundation for Parkinson’s Disease and the Toyota Foundation. http://dx.doi.org/10.1016/j.sleep.2015.02.1424
Sensorimotor gating deficits in multiple system atrophy: Comparison with Parkinson’s disease and idiopathic REM sleep behavior disorder M. Zoetmulder 1,2, H. Biernat 2, M. Nikolic 3, L. Korbo 2, P. Jennum 4 1 Danish Center for Sleep Medicine, Glostrup Hospital, Denmark 2 Department of Neurology, Bispebjerg Hospital, Denmark 3 Department of Clinical Neurophysiology, Glostrup Hospital, Denmark
Abstracts/Sleep Medicine 16 (2015) S2–S199
2
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Denmark 3 H. Lundbeck A/S, Denmark 4 Center for Healthy Aging, University of Copenhagen, Denmark
Introduction: Patients with idiopathic REM sleep behavior disorder (iRBD) are at high risk of developing Parkinson’s disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/ NREM transitions. Materials and methods: We determined the frequency of wake/ sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 36 patients with PD (52–78 years, 12F/24M), 31 patients with iRBD (45–76 years, 5F/26M), 25 patients with periodic leg movement (PLM) (37–77 years, 12F/13M) and 23 controls (40–73 years, 16F/ 7M). Measures were computed based on automatic data-driven labeled sleep staging. Results: Patients with PD showed significantly lower REM sleep stability than controls and patients with PLM and iRBD. Patients with PD also had significantly lower NREM sleep stability and significantly more transitions between REM and NREM sleep than controls, but not compared with patients with iRBD or PLM. Patients with iRBD had significantly lower REM sleep stability compared with patients with PLM and controls. Conclusion: We conclude that W, NREM and REM sleep stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease. Acknowledgements: The PhD project is supported by grants from H. Lundbeck A/S, the Lundbeck Foundation, the Technical University of Denmark and the Center for Healthy Aging, University of Copenhagen. http://dx.doi.org/10.1016/j.sleep.2015.02.1422
Olfactory dysfunction in patients with Parkinson’s disease complicated REM sleep behavior disorder T. Nomura 1, Y. Inoue 2, M. Kishi 1, K. Nakashima 1 1 Tottori University, Japan 2 Tokyo Medical University
Introduction: Olfactory dysfunction and REM sleep behavior disorder (RBD) frequently occurred in patients with Parkinson’s disease (PD). These symptoms were paid attention to not only premotor symptoms of PD but also risk factor to dementia in PD. We evaluated the association between these symptoms in PD. Materials and methods: Thirty eight patients with PD were examined olfactory examination (Odor Stick Identification Test for Japanese: OSIT-J) and polysomnogram (PSG). We divided these patients into PD with clinical RBD, PD with subclinical RBD, and PD with normal REM sleep. These three groups were compared on the proportion of subjective olfactory dysfunction, each category of OSIT-J, and total scores of OSIT-J by chi square test and a one-way analysis of variance. Results: Nineteen were categorized as PD with clinical RBD, 7 as PD with subclinical RBD, and 12 as PD with normal REM sleep. There were no significant differences of clinical backgrounds. However, PD with clinical RBD had more patients with subjective olfactory dysfunction than the other groups . There were significant difference of total OSIT-J score among three groups (PD with clinical RBD: 3.4 ± 2.3,
PD with subclinical RBD: 4.6 ± 2.0, PD with normal REM sleep: 6.2 ± 3.1, p = 0.014). A post hoc test revealed that PD group with clinical RBD had significant lower than that with normal REM sleep (p = 0.011). PD patients with normal REM sleep had more patients with correct of rose, gas, and perfume than those with clinical RBD. Conclusion: Olfactory dysfunction was associated with RBD findings. Both these symptoms were important for premotor symptoms and development of risk in patients with PD. http://dx.doi.org/10.1016/j.sleep.2015.02.1423
Increased motor activity during REM sleep is linked with dopamine-function in idiopathic REM sleep behaviour disorder and Parkinson’s disease M. Zoetmulder 1,2, M. Nikolic 3, H. Biernat 2, L. Korbo 2, L. Friberg 4, P. Jennum 5 1 Danish Center for Sleep Medicine, Glostrup Hospital, Denmark 2 Department of Neurology, Bispebjerg Hospital, Denmark 3 Department of Clinical Neurophysiology, Glostrup Hospital, Denmark 4 Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Denmark 5 Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Denmark
Introduction: Idiopathic rapid eye movement sleep behavior disorder (iRBD) is characterized by impaired motor inhibition and dream-enacting behavior during REM sleep. Longitudinal studies have shown that iRBD-patients have increased risk of developing an α-synucleinopathy. We investigated the relationship between the nigrostriatal-dopamine-system and muscle activity during sleep in iRBD and Parkinson’s. Materials and methods: Ten iRBD patients, 10 PD patients with PD, 10 PD patients without RBD, and 10 healthy controls were included and assessed with 123I-FP-CIT SPECT, neurological examination, and polysomnography. Results: IRBD patients and PD patients with RBD had increased phasic EMG-activity compared with healthy controls. 123I-FP-CIT uptake in the putamen-region was highest in controls, followed by iRBD patients, and lowest in PD patients. In iRBD patients EMGactivity in the mentalis muscle was correlated to 123I-FP-CIT uptake in the putamen. In PD patients EMG-activity was correlated to antiParkinson medication. Conclusion: Our results support the hypothesis that increased EMG-activity during REM sleep is at least partly linked to the nigrostriatal dopamine system in iRBD, and with dopaminergic medication in PD. Acknowledgements: This work was supported by the Lundbeck Foundation, the National Foundation for Parkinson’s Disease and the Toyota Foundation. http://dx.doi.org/10.1016/j.sleep.2015.02.1424
Sensorimotor gating deficits in multiple system atrophy: Comparison with Parkinson’s disease and idiopathic REM sleep behavior disorder M. Zoetmulder 1,2, H. Biernat 2, M. Nikolic 3, L. Korbo 2, P. Jennum 4 1 Danish Center for Sleep Medicine, Glostrup Hospital, Denmark 2 Department of Neurology, Bispebjerg Hospital, Denmark 3 Department of Clinical Neurophysiology, Glostrup Hospital, Denmark