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REVIEW ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 8  |  Page : 966-973

Relationships between Rapid Eye Movement Sleep Behavior Disorder and Neurodegenerative Diseases: Clinical Assessments, Biomarkers, and Treatment


Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Correspondence Address:
Dr. Shu-Qin Zhan
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.229886

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Objective: Rapid eye movement sleep behavior disorder (RBD) is characterized by dream enactment and loss of muscle atonia during rapid eye movement sleep. RBD is closely related to α-synucleinopathies including Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. Many studies have investigated the markers of imaging and neurophysiological, genetic, cognitive, autonomic function of RBD and their predictive value for neurodegenerative diseases. This report reviewed the progress of these studies and discussed their limitations and future research directions. Data Sources: Using the combined keywords: “RBD”, “neurodegenerative disease”, “Parkinson disease”, and “magnetic resonance imaging”, the PubMed/MEDLINE literature search was conducted up to January 1, 2018. Study Selection: A total of 150 published articles were initially identified citations. Of the 150 articles, 92 articles were selected after further detailed review. This study referred to all the important English literature in full. Results: Single-nucleotide polymorphisms in SCARB2 (rs6812193) and MAPT (rs12185268) were significantly associated with RBD. The olfactory loss, autonomic dysfunction, marked electroencephalogram slowing during both wakefulness and rapid eye movement sleep, and cognitive impairments were potential predictive markers for RBD conversion to neurodegenerative diseases. Traditional structural imaging studies reported relatively inconsistent results, whereas reduced functional connectivity between the left putamen and substantia nigra and dopamine transporter uptake demonstrated by functional imaging techniques were relatively consistent findings. Conclusions: More longitudinal studies should be conducted to evaluate the predictive value of biomarkers of RBD. Moreover, because the glucose and dopamine metabolisms are not specific for assessing cognitive cognition, the molecular metabolism directly related to cognition should be investigated. There is a need for more treatment trials to determine the effectiveness of interventions of RBD on preventing the conversion to neurodegenerative diseases.

 

 Abstract in Chinese

快速眼球运动睡眠期行为障碍和神经退行性病的关联:临床评估、生物学标记和治疗

摘要

目标:快速眼球运动睡眠期行为障碍(RBD)是一种以REM睡眠期间伴随梦境及肢体活动为特征的睡眠疾病。RBD与α-突触核蛋白病密切相关,包括帕金森病、路易体痴呆和多系统萎缩。许多研究探讨RBD的神经影像和神经生理学、遗传学、认知、自主神经功能相关的生物学标记,及其对神经退行性疾病的预测价值。本综述对这些研究的进展进行回顾,并讨论其局限性和未来研究方向。
数据来源:使用“RBD”、“神经退行性疾病”、“帕金森病”和“磁共振成像”结合的关键词,PubMed / MEDLINE文献检索到2018年1月1日。
文献选择:共有150篇已发表文章被初步确定为引文,其中92篇文章经过进一步详细审查后被选中。本综述全面分析了所有重要的英文全文。
结果:SCARB2(rs6812193)和MAPT(rs12185268)的单核苷酸多态性与RBD显著相关。 清醒和快速眼动睡眠期间EEG减慢、嗅觉丧失、自主神经功能障碍、认知障碍是RBD转化为神经退行性疾病的潜在预测标记。传统的结构影像学研究结果相对不一致,而功能成像技术显示的左侧壳核和黑质的功能连接、多巴胺转运蛋白摄取的降低是相对一致的结果。
结论:应进行更多的纵向研究来评估生物标记物对RBD转化为神经退行性疾病的预测价值。 此外,葡萄糖和多巴胺代谢的结果对于评估认知功能并不特异,因此应探讨与认知功能直接相关的代谢分子在RBD发病中的参与作用。另外需要更多的临床试验来确定RBD干预措施对于预防神经退行性疾病的有效性。



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