Complex paroxysmal nocturnal behaviors in Parkinson's disease

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Complex paroxysmal nocturnal motor behavioral disorders (CPNBs) are frequently reported in patients with Parkinson's disease (PD). REM sleep behavior disorder (RBD) is reported in at least a third of PD patients, although CPNB episodes can also occur on arousal from NREM sleep. It is important to establish the nature of CPNBs occurring in PD, as the different types have different neurobiological significance and clinical importance, and also different treatments. Ninety-six PD patients with and without CPNBs were submitted to overnight in-hospital video-polysomnography. Of these, 76 (47 men) were included in the study analysis: these were patients in whom it was possible to establish the presence or absence of CPNBs and to obtain a clear-cut diagnosis of the nature of the CPNBs reported. The CPNBs were found to be RBD episodes in 39 cases (87%) and nonRBD episodes in 6 (13%) (arousal-related episodes arising from NREM sleep in 3 cases and from REM sleep in 2 cases, parasomnia overlapping syndrome in 1 case). In 4 of the 6 subjects with nonRBD episodes, these occurred upon arousal at the end of an obstructive apnoeic event. Our data confirm that CPNBs in PD are, in most cases, RBD episodes. However, arousal-related episodes accounted for 13% of the CPNBs observed in our sample and occurred in close temporal association with sleep-disordered breathing (SDB). The arousal system is defective in extrapyramidal diseases due to neurodegenerative changes involving the brain stem reticular network; against this background, a trigger effect of SDB on CPNBs, through induction of abrupt arousal, may be hypothesized.

Original languageEnglish
Pages (from-to)985-990
Number of pages6
JournalMovement Disorders
Volume25
Issue number8
DOIs
Publication statusPublished - Jun 15 2010

Fingerprint

Arousal
Parkinson Disease
REM Sleep Behavior Disorder
Sleep Apnea Syndromes
Sleep
Parasomnias
Polysomnography
REM Sleep
Brain Stem

Keywords

  • Arousal
  • Parkinson's disease
  • Paroxysmal nocturnal manifestations
  • REM sleep behavior disorder
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)

Cite this

Complex paroxysmal nocturnal behaviors in Parkinson's disease. / Manni, Raffaele; Terzaghi, Michele; Repetto, Alessandra; Zangaglia, Roberta; Pacchetti, Claudio.

In: Movement Disorders, Vol. 25, No. 8, 15.06.2010, p. 985-990.

Research output: Contribution to journalArticle

@article{5e17038219374bb682db5353b2829c63,
title = "Complex paroxysmal nocturnal behaviors in Parkinson's disease",
abstract = "Complex paroxysmal nocturnal motor behavioral disorders (CPNBs) are frequently reported in patients with Parkinson's disease (PD). REM sleep behavior disorder (RBD) is reported in at least a third of PD patients, although CPNB episodes can also occur on arousal from NREM sleep. It is important to establish the nature of CPNBs occurring in PD, as the different types have different neurobiological significance and clinical importance, and also different treatments. Ninety-six PD patients with and without CPNBs were submitted to overnight in-hospital video-polysomnography. Of these, 76 (47 men) were included in the study analysis: these were patients in whom it was possible to establish the presence or absence of CPNBs and to obtain a clear-cut diagnosis of the nature of the CPNBs reported. The CPNBs were found to be RBD episodes in 39 cases (87{\%}) and nonRBD episodes in 6 (13{\%}) (arousal-related episodes arising from NREM sleep in 3 cases and from REM sleep in 2 cases, parasomnia overlapping syndrome in 1 case). In 4 of the 6 subjects with nonRBD episodes, these occurred upon arousal at the end of an obstructive apnoeic event. Our data confirm that CPNBs in PD are, in most cases, RBD episodes. However, arousal-related episodes accounted for 13{\%} of the CPNBs observed in our sample and occurred in close temporal association with sleep-disordered breathing (SDB). The arousal system is defective in extrapyramidal diseases due to neurodegenerative changes involving the brain stem reticular network; against this background, a trigger effect of SDB on CPNBs, through induction of abrupt arousal, may be hypothesized.",
keywords = "Arousal, Parkinson's disease, Paroxysmal nocturnal manifestations, REM sleep behavior disorder, Sleep-disordered breathing",
author = "Raffaele Manni and Michele Terzaghi and Alessandra Repetto and Roberta Zangaglia and Claudio Pacchetti",
year = "2010",
month = "6",
day = "15",
doi = "10.1002/mds.22990",
language = "English",
volume = "25",
pages = "985--990",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley and Sons Inc.",
number = "8",

}

TY - JOUR

T1 - Complex paroxysmal nocturnal behaviors in Parkinson's disease

AU - Manni, Raffaele

AU - Terzaghi, Michele

AU - Repetto, Alessandra

AU - Zangaglia, Roberta

AU - Pacchetti, Claudio

PY - 2010/6/15

Y1 - 2010/6/15

N2 - Complex paroxysmal nocturnal motor behavioral disorders (CPNBs) are frequently reported in patients with Parkinson's disease (PD). REM sleep behavior disorder (RBD) is reported in at least a third of PD patients, although CPNB episodes can also occur on arousal from NREM sleep. It is important to establish the nature of CPNBs occurring in PD, as the different types have different neurobiological significance and clinical importance, and also different treatments. Ninety-six PD patients with and without CPNBs were submitted to overnight in-hospital video-polysomnography. Of these, 76 (47 men) were included in the study analysis: these were patients in whom it was possible to establish the presence or absence of CPNBs and to obtain a clear-cut diagnosis of the nature of the CPNBs reported. The CPNBs were found to be RBD episodes in 39 cases (87%) and nonRBD episodes in 6 (13%) (arousal-related episodes arising from NREM sleep in 3 cases and from REM sleep in 2 cases, parasomnia overlapping syndrome in 1 case). In 4 of the 6 subjects with nonRBD episodes, these occurred upon arousal at the end of an obstructive apnoeic event. Our data confirm that CPNBs in PD are, in most cases, RBD episodes. However, arousal-related episodes accounted for 13% of the CPNBs observed in our sample and occurred in close temporal association with sleep-disordered breathing (SDB). The arousal system is defective in extrapyramidal diseases due to neurodegenerative changes involving the brain stem reticular network; against this background, a trigger effect of SDB on CPNBs, through induction of abrupt arousal, may be hypothesized.

AB - Complex paroxysmal nocturnal motor behavioral disorders (CPNBs) are frequently reported in patients with Parkinson's disease (PD). REM sleep behavior disorder (RBD) is reported in at least a third of PD patients, although CPNB episodes can also occur on arousal from NREM sleep. It is important to establish the nature of CPNBs occurring in PD, as the different types have different neurobiological significance and clinical importance, and also different treatments. Ninety-six PD patients with and without CPNBs were submitted to overnight in-hospital video-polysomnography. Of these, 76 (47 men) were included in the study analysis: these were patients in whom it was possible to establish the presence or absence of CPNBs and to obtain a clear-cut diagnosis of the nature of the CPNBs reported. The CPNBs were found to be RBD episodes in 39 cases (87%) and nonRBD episodes in 6 (13%) (arousal-related episodes arising from NREM sleep in 3 cases and from REM sleep in 2 cases, parasomnia overlapping syndrome in 1 case). In 4 of the 6 subjects with nonRBD episodes, these occurred upon arousal at the end of an obstructive apnoeic event. Our data confirm that CPNBs in PD are, in most cases, RBD episodes. However, arousal-related episodes accounted for 13% of the CPNBs observed in our sample and occurred in close temporal association with sleep-disordered breathing (SDB). The arousal system is defective in extrapyramidal diseases due to neurodegenerative changes involving the brain stem reticular network; against this background, a trigger effect of SDB on CPNBs, through induction of abrupt arousal, may be hypothesized.

KW - Arousal

KW - Parkinson's disease

KW - Paroxysmal nocturnal manifestations

KW - REM sleep behavior disorder

KW - Sleep-disordered breathing

UR - http://www.scopus.com/inward/record.url?scp=77953497443&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953497443&partnerID=8YFLogxK

U2 - 10.1002/mds.22990

DO - 10.1002/mds.22990

M3 - Article

VL - 25

SP - 985

EP - 990

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

IS - 8

ER -