REM-Schlaf-Verhaltensstörung und andere frühe Indikatoren des Morbus Parkinson

B. M. Schmidl; M. M. Unger

doi:10.1055/s-0038-1627621

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2015; 34(09): 691-696
DOI: 10.1055/s-0038-1627621

Ärztefortbildung Karlsruhe

Schattauer GmbH

REM-Schlaf-Verhaltensstörung und andere frühe Indikatoren des Morbus Parkinson

Schlüssel zur Erprobung neuroprotektiver Therapien?REM sleep behaviour disorder and other early markers of Parkinson’s disease

B. M. Schmidl

¹Universitätsklinikum des Saarlandes, Klinik für Neurologie, Homburg/Saar

,

M. M. Unger

¹Universitätsklinikum des Saarlandes, Klinik für Neurologie, Homburg/Saar

› Institutsangaben

Abstract

Zusammenfassung

Die Diagnose eines Morbus Parkinson erfolgt klinisch bei Vorliegen der definierenden motorischen Symptome (Bradykinese, Tremor, Rigor, posturale Instabilität) und nach Ausschluss anderer Differenzialdiagnosen eines ParkinsonSyndroms. Bereits viele Jahre vor dem Auftreten der ersten motorischen Symptome eines Parkinson können bestimmte nicht motorische Symptome (z. B. Hyposmie, Schlafstörungen, Obstipation) auftreten. Die meisten dieser prämotorischen Marker sind unspezifisch und haben jeweils isoliert betrachtet einen niedrigen Vorhersagewert für die spätere Entwicklung eine M. Parkinson. Die REM-Schlaf-Verhaltensstörungen, die klinisch durch das Ausleben von aktionsgeladenen Träumen gekennzeichnet ist, zählt zu den spezifischsten Risikomarkern für die spätere Entwicklung eines M. Parkinson. Ein Teil der Patienten mit REM-Schlaf-Verhaltensstörung entwickelt im Verlauf auch andere neurodegenerative Erkrankungen, insbesondere andere alpha-Synukleinopathien. Der positive prädiktive Wert der REM-Schlaf-Verhaltensstörung für die spätere Entwicklung eines M. Parkinson ist höher, wenn zeitgleich weitere prämotorische Marker des M. Parkinson vorliegen.

Summary

Diagnostic criteria for Parkinson’s disease are based on the presence of motor symptoms (bradykinesia, tremor, rigidity, postural instability) and the exclusion of other causes of parkinsonism. Some non-motor symptoms (e.g. hyposmia, sleep disorders and constipation) may emerge many years before the onset of the classical motor symptoms of Parkinson’s disease. Most of these early nonmotor symptoms are unspecific and have a low positive predictive value for the subsequent development of Parkinson’s disease. REM sleep behaviour disorder (a parasomnia that is clinically characterized by dream enactment) is one of the most specific risk markers for Parkinson’s disease. However, some patients with REM sleep behaviour disorder develop other neurodegenerative disorders, especially other alpha-synucleinopathies. The positive predictive value of REM sleep behaviour disorder for Parkinson’s disease is even higher in cases in which REM sleep behaviour disorder is accompanied by other premotor markers of Parkinson’s disease.

Schlüsselwörter

REM-Schlaf-Verhaltensstörung - Morbus Parkinson - Neurodegeneration - prämotorische Risikomarker

Keywords

REM sleep behaviour disorder - Parkinson’s disease - neurodegeneration - premotor risk markers

Volltext

Referenzen

Literatur
1 International Classification of Sleep Disorders. 3rd Edition.. American Academy of Sleep Medicine; 2014
2 Abbott RD, Petrovitch H, White LR, Masaki KH, Tanner CM, Curb JD. et al. Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology 2001; 57 (03) 456-62.
3 Becker G, Seufert J, Bogdahn U, Reichmann H, Reiners K. Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography. Neurology 1995; 45 (01) 182-4.
4 Berg D, Behnke S, Seppi K, Godau J, Lerche S, Mahlknecht P. et al. Enlarged hyperechogenic substantia nigra as a risk marker for Parkinson’s disease. Mov Disord 2013; 28 (02) 216-9.
5 Bjornara KA, Dietrichs E, Toft M. REM sleep behavior disorder in Parkinson’s disease – is there a gender difference?. Parkinsonism Relat Disord 2013; 19 (01) 120-2.
6 Boeve BF, Silber MH, Ferman TJ. Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med 2003; 04 (04) 281-4.
7 Boeve BF, Silber MH, Saper CB, Ferman TJ, Dickson DW, Parisi JE. et al. Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease. Brain 2007; 130 (Pt 11): 2770-88.
8 Braak H, de Vos RA, Bohl J, Del Tredici K. Gastric alpha-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett 2006; 396 (01) 67-72.
9 Braak H, Del Tredici K, Rub U, de Vos RA, Jansen ENSteur, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 2003; 24 (02) 197-211.
10 Comella CL. Sleep disorders in Parkinson’s disease: an overview. Mov Disord 2007; 22 (Suppl. 17) S367-73.
11 Dauvilliers Y, Postuma RB, Ferini-Strambi L, Arnulf I, Hogl B, Manni R. et al. Family history of idiopathic REM behavior disorder: a multicenter case-control study. Neurology 2013; 80 (24) 2233-5.
12 den HJW, Bethlem J. The distribution of Lewy bodies in the central and autonomic nervous systems in idiopathic paralysis agitans. J Neurol Neurosurg Psychiatry 1960; 23: 283-90.
13 Eisensehr I, Linke R, Noachtar S, Schwarz J, Gildehaus FJ, Tatsch K. Reduced striatal dopamine transporters in idiopathic rapid eye movement sleep behaviour disorder. Comparison with Parkinson’s disease and controls. Brain 2000; 123 (Pt 6): 1155-60.
14 Fantini ML, Farini E, Ortelli P, Zucconi M, Manconi M, Cappa S. et al. Longitudinal study of cognitive function in idiopathic REM sleep behavior disorder. Sleep 2011; 34 (05) 619-25.
15 Ferini-Strambi L, Oertel W, Dauvilliers Y, Postuma RB, Marelli S, Iranzo A. et al. Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study. J Neurol 2014; 261 (06) 1112-8.
16 Iranzo A, Fernandez-Arcos A, Tolosa E, Serradell M, Molinuevo JL, Valldeoriola F. et al. Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients. PLoS One 2014; 09 (02) e89741.
17 Iranzo A, Lomena F, Stockner H, Valldeoriola F, Vilaseca I, Salamero M. et al. Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study [corrected]. Lancet Neurol 2010; 09 (11) 1070-7.
18 Kashihara K, Imamura T, Shinya T. Cardiac 123I-MIBG uptake is reduced more markedly in patients with REM sleep behavior disorder than in those with early stage Parkinson’s disease. Parkinsonism Relat Disord 2010; 16 (04) 252-5.
19 Kimura K, Tachibana N, Kohyama J, Otsuka Y, Fukazawa S, Waki R. A discrete pontine ischemic lesion could cause REM sleep behavior disorder. Neurology 2000; 55 (06) 894-5.
20 Olson EJ, Boeve BF, Silber MH. Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. Brain 2000; 123 (Pt 2): 331-9.
21 Ponsen MM, Stoffers D, Booij J, van Eck-Smit BL, Wolters E, Berendse HW. Idiopathic hyposmia as a preclinical sign of Parkinson’s disease. Ann Neurol 2004; 56 (02) 173-81.
22 Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology 2009; 72 (15) 1296-300.
23 Schenck CH, Boeve BF, Mahowald MW. Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: a 16-year update on a previously reported series. Sleep Med 2013; 14 (08) 744-8.
24 Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW. Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep 1986; 09 (02) 293-308.
25 Schenck CH, Bundlie SR, Mahowald MW. Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder. Neurology 1996; 46 (02) 388-93.
26 Schenck CH, Bundlie SR, Patterson AL, Mahowald MW. Rapid eye movement sleep behavior disorder. A treatable parasomnia affecting older adults. JAMA 1987; 257 (13) 1786-9.
27 Scherfler C, Frauscher B, Schocke M, Iranzo A, Gschliesser V, Seppi K. et al. White and gray matter abnormalities in idiopathic rapid eye movement sleep behavior disorder: a diffusion-tensor imaging and voxel-based morphometry study. Ann Neurol 2011; 69 (02) 400-7.
28 Stiasny-Kolster K, Doerr Y, Moller JC, Hoffken H, Behr TM, Oertel WH. et al. Combination of ‘idiopathic’ REM sleep behaviour disorder and olfactory dysfunction as possible indicator for alphasynucleinopathy demonstrated by dopamine transporter FP-CIT-SPECT. Brain 2005; 128 (Pt 1): 126-37.
29 Stockner H, Iranzo A, Seppi K, Serradell M, Gschliesser V, Sojer M. et al. Midbrain hyperechogenicity in idiopathic REM sleep behavior disorder. Mov Disord 2009; 24 (13) 1906-9.
30 Takeuchi N, Uchimura N, Hashizume Y, Mukai M, Etoh Y, Yamamoto K. et al. Melatonin therapy for REM sleep behavior disorder. Psychiatry Clin Neurosci 2001; 55 (03) 267-9.
31 Unger MM, Belke M, Menzler K, Heverhagen JT, Keil B, Stiasny-Kolster K. et al. Diffusion tensor imaging in idiopathic REM sleep behavior disorder reveals microstructural changes in the brainstem, substantia nigra, olfactory region, and other brain regions. Sleep 2010; 33 (06) 767-73.
32 Unger MM, Moller JC, Stiasny-Kolster K, Mankel K, Berg D, Walter U. et al. Assessment of idiopathic rapid-eye-movement sleep behavior disorder by transcranial sonography, olfactory function test, and FP-CIT-SPECT. Mov Disord 2008; 23 (04) 596-9.
33 Xi Z, Luning W. REM sleep behavior disorder in a patient with pontine stroke. Sleep Med 2009; 10 (01) 143-6.