Biomarkers of neurodegeneration in isolated and antidepressant-related rapid eye movement sleep behavior disorder
EUROPEAN JOURNAL OF NEUROLOGY(2024)
摘要
Background and purposeThis study compared the features of isolated rapid eye movement (REM) sleep behavior disorder (iRBD) and antidepressant-related REM sleep behaviour disorder (RBD) with the aim of highlighting markers that might distinguish the two entities.MethodsThe observational cohort study included RBD patients with and without antidepressant use (antiD+ and antiD- patients, respectively), without cognitive impairment and parkinsonism. Clinical features of RBD, subtle motor and non-motor symptoms of parkinsonism, sleep architecture, REM atonia index, dopamine transporter-single photon emission computed tomography (DAT-SPECT) and skin biopsies for the intraneuronal alpha-synuclein (alpha-syn), were evaluated in the baseline work-up.ResultsThirty-nine patients, 10 antiD+ and 29 antiD-, were included. AntiD+ patients (more frequently female) reported more psychiatric symptoms, less violent dream enactment, and less frequent hyposmia. Dermal alpha-syn was detected in 93.1% of antiD- versus 30% of antiD+ patients (p = 0.00024). No differences appeared in other motor and non-motor symptoms, Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III score, DAT-SPECT, or polysomnographic features.ConclusionsPatients with antidepressant-related RBD have clinical and neuropathological features suggesting a lower risk of evolution than those with iRBD.
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关键词
alpha-synuclein,antidepressant-related REM sleep behavior disorder,skin biopsy
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