论文部分内容阅读
Background: It has been known that Rapid eye movement (REM) behavior disorder (RBD) is closely related with synucleinopathies, especially Parkinsons disease (PD).Diagnosis of RBD requires not only clinical manifestation but also presence of REM sleep without atonia (RSWA) on polysomnography (PSG).As an effective and economic tool for screening RBD, RBD questionnaire (RBDQ-HK) costs less time and money and therefore, is widely used in cross-sectional study.The sensitivity and specificity of RBDQ-HK is 82.2% and 86.9% respectively; it also has high internal consistency and test-retest reliability.Besides RBD, sleep disorders are also common in PD patients, which is seldom recognized or well-treated.Therefore, we made a cross-sectional study in order to find out the prevalence of RBD and sleep disorders in PD patients in central China.Objective: To have a robust look on the prevalence of RBD in PD patients from Wuhan and Xiangyang city through a questionnaire-based study and find out whether there is difference in gender and age predominance or correlation between onset symptom type and RBD.The prevalence of sleep disorders and its characteristics in PD patients is also investigated through Parkinsons Disease Sleep Scale (PDSS-2) and Epworth Sleepiness Scale (ESS).Methods: 126 questionnaires including personal information, drug use, PDSS-2, ESS, and RBDQ-HK was sent to PD patients in Wuhan and Xiangyang City with 91 giving back (58 males, 33 females).SPSS 16.0 was used to analysis the data.Results: RBDQ-HK is composed of two components: one is related with dreams while the other is related with behaviors during sleep.Of the 91 patients, scores related with dreams range from 0 to 70, with an average of 17.32 (38.1%) patients have scores higher than 18 (the best cut-off for scores related with dreams).Scores related with behaviors during sleep range from 0 to 48, with an average of 9 and 41 patients have scores higher than 8, which corresponds to the best cut-off value.Of the 32 patients who have scores higher than 18, 5 patients have bradykinesia as the onset symptom, 10 static tremor, 1 myotonia, 3 abnormal gestures.However, there are also 10 patients showing a combination of symptoms above.PDSS-2 is used to evaluate the quality of sleep in last 7 days, as well as the efficiency of treatment of PD.It consists of 15 items which can be divided into three aspects: motor symptoms at night, PD symptoms at night, and disturbed sleep.ESS is used to evaluate the degree of somnolence during daytime.Results show that 10 (11.0%) patients have motor symptoms at night 2-3 days per week, and the number corresponding to PD symptoms at night and disturbed sleep is 9 (9.9%), and 34 (37.4%) respectively.ESS show that 39 (42.9%) patients are mild abnormal (scores higher than 8) and 33 (36.3%) patients have somnolence during daytime (scores higher than 10).Nonparametric analysis show there is no significant difference in RBDQ-HK scores between males and females and between patients older and younger than 65 years old.Conclusion: Of the total 91 PD patients from Wuhan and Xiangyang City, 48.8% have RBD according to the results of RBDQ-HK though the diagnosis needs to be proved by PSG.Significant difference of RBDQ-HK score between male and female is not found.From PDSS-2 and ESS, we find that at least 37.4% PD patients have sleep disorders with the frequency of 2-3 days per week and 36.3% PD patients have somnolence during daytime.