临床及亚临床快速眼动睡眠期行为障碍与帕金森病认知功能的相关性

The correlations between the clinical and subclinical REM sleep behavior disorder and cognitive function in patients with Parkinson′s disease

目的探讨快速眼动睡眠期行为障碍(REM sleep behavior disorder,RBD)及亚临床快速眼动睡眠期行为障碍(subclinical REM sleep behavior disorder,s RBD)与帕金森病(Parkinso's disease,PD)患者认知功能的关系。方法选择南昌大学第二附属医院53例PD患者,记录患者的年龄、性别、学历等一般情况。排除存在痴呆的PD患者,以面对面的方式进行相关量表评估,包括蒙特利尔认知量表评分(Montrealcognitive function score,MoCA)、帕金森病综合评分量表(Unified Parkinson Disease Rating Scale,UPDRS)、帕金森病睡眠量表(Parkinson Disease Sleep Scale,PDSS)等。使用多导睡眠图监测患者的睡眠质量,并进行分组:PD合并RBD组(PD-RBD)、PD合并s RBD组(PD-s RBD)、PD正常组(PD-REM),比较3组之间认知功能的差异。结果 (1)PD-RBD组的MoCA总分较PD-REM组低(P=0.032)。(2)PD-s RBD与PD-REM组的认知功能差异无统计学意义。(3)PD-RBD组病程较PD-s RBD组更长(P=0.021)。结论 RBD可能是PD患者认知功能障碍的一个重要相关因素;s RBD对PD的认知功能无明显相关;尚不清楚s RBD是否会进展为RBD,仍需进一步的研究。

Objective To investigate the relationships between the clinical and subclinical REM sleepbehavior disorder（s RBD）and the cognitive function in patients with PD. Methods We enrolled 53 patients withPD from the Second Affiliated Hospital of Nanchang University. The age,gender and education level of eachpatient were recorded. Patients with dementia were excluded. The correlative scales were assessed by the form offace to face,including Montreal cognitive function score（Mo CA）,Unified Parkinson Disease Rating Scale（UPDRS）,Parkinson Disease Sleep Scale（PDSS）and so on. The sleep quality was assessed by polysomnography（PSG）,meanwhile PD patients were divided into the RBD group（PD-RBD）,the subclinical RBD group（PD-s RBD）andthe normal REM group（PD-REM）based on the polysomnography. The cognitive function was compared among thethree groups. Results（1）Mo CA score of PD patients in the RBD group was lower than that in the normal REMgroup（P = 0.032.（2）No significant difference was observed in the cognitive function between the s RBD groupand the normal REM group.（3）Length of morbidity of PD patients with RBD was longer than that of PD patientswith s RBD（P = 0.021）. Conclusions The presence of RBD may be an important relative factor for the development of cognitive dysfunction in PD patients. We haven′t detected that the subclinical RBD was associated with thecognitive dysfunction in patients with PD. It is not clear whether the subclinical RBD in PD patients develops toRBD in all patients,which needs further investigation.