帕金森病伴快速眼动睡眠期行为障碍

Parkinson Disease With Rapid Eye Movement Sleep Behavior Disorder

快速眼动(REM)睡眠期行为障碍(RBD)是REM睡眠期出现肌张力缺失并伴有与噩梦相关的复杂运动为特征的发作性疾病,RBD与帕金森病(PD)密切相关,在PD患者中的发生率高。伴RBD的PD患者临床上多表现为强直型,病程更长,运动症状、非运动症状更重,生活能力及生活质量的损害更突出。RBD的病理生理机制可能主要涉及脑桥被盖部、蓝斑/蓝斑下区复合体及其投射通路功能的紊乱。诊断RBD主要依据特征性临床表现及视频多导睡眠图(v-PSG)的监测结果。治疗上除了积极干预PD外,应对患者及其床伴采取保护措施;当患者的异常睡眠行为对其造成严重的困扰并具有危险性时,需给予药物治疗。

Rapid eye movement（ REM） sleep behavior disorder（ RBD） is characterized by lack of muscle atonia during REM sleep and enactment of dream content. RBD is associated with Parkinson disease（ PD） and has high incidence in PD patients. PD patient with RBD mainly presents rigid type,has longer disease duration,more severe motor and non-motor symptoms and poorer activity of daily living and life quality. The pathophysiological mechanisms of RBD may be related to dysfunctions of pontine tegmentum,locus coeruleus / sub-locus coeruleus complex and related projections. The diagnosis of RBD depends on clinical histories and video-polysomnography（ v-PSG）. Besides treatment for PD,protective measures have to be taken for patients and their sleep partners. If abnormal behaviors during sleep cause distress and danger,patients should be given drug therapy.