Abstract:
Objective To investigate the changes of transcranial sonography (TCS) in patients with rapid eye movement sleep behavior disorder (RBD). Methods Fifteen patients fulfilled the diagnostic criteria of RBD according to International Classification of Sleep Disorders (ICSD, 2nd edition). Under the monitor of polysomnography (PSG), the sleep architectures of all RBD cases were evaluated by Polysmith software and visual analysis. Furthermore, all RBD patients and 15 normal controls underwent TCS. Cases with substantia nigra echo intensity over Ⅲ grade and substantia nigra area over 0.20 cm2 were supposed to be hyperechogenicity. Additionally, the width of the third ventricle was measured and whether there was hyperechogenicity in basal ganglia was evaluated. The cognitive functions were evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results RBD patients presented typical clinical manifestations and electrophysiologic changes. No significant difference (P = 0.080, 0.109) was found in the comparison of hyperechogenicity rate on substantia nigra (6/15) and basal ganglia (7/15) in RBD patients and normal controls (1/15, 2/15). No significant difference in the comparison of MoCA was found in RBD patients with or without substantia nigra hyperechogenicity (P = 0.075). The RBD patients with hyperechogenicity on basal ganglia had higher MMSE scores than those without hyperechogenicity on basal ganglia, and the difference was significant (P = 0.021). Conclusions RBD which is suggested as the prodromal period of synucleinopathy may present hyperechogenicity in substantia nigra and basal ganglia on TCS. TCS could detect subclinical changes of brain and evaluate the risk of synucleinopathy.
Key words:
REM sleep behavior disorder,
Echoencephalography
摘要：
目的 探讨快速眼动睡眠期行为障碍患者经颅脑实质超声改变。方法 符合睡眠障碍国际分类第2 版快速眼动睡眠期行为障碍诊断标准的15 例患者（RBD 组）和15 例正常对照受试者，于多导睡眠图监测后通过经颅脑实质超声检查并测量中脑黑质高回声、基底节高回声、第三脑室宽度；简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA）评价认知功能。结果 快速眼动睡眠期行为障碍患者具有典型的临床表现和电生理学改变。RBD 组黑质高回声（6/15）、基底节高回声（7/15）阳性检出率，与正常对照组（1/15 和2/15）之间差异无统计学意义（P = 0.080，0.109）。RBD 组伴与不伴黑质高回声患者MoCA 评分差异无统计学意义（P = 0.075）；但RBD 组伴基底节高回声患者MMSE 评分高于不伴基底节高回声患者（P = 0.021）。结论 快速眼动睡眠期行为障碍作为突触共核蛋白病前驱期，经颅脑实质超声可表现为黑质和基底节高回声，且伴不同结局。经颅脑实质超声可以检测出脑亚临床改变，评价突触共核蛋白病风险。
关键词:
REM 睡眠行为障碍,
脑超声描记术
LI Xu-dong, XUE Shuang, HOU Chun-lei, JIA Shu-hong, QIAO Ya-nan, ZHOU Zhi, WEI Kun, ZHENG Wen-jing, RONG Pei, JIAO Jin-song. Study on transcranial sonography in patients with idiopathic rapid eye movement sleep behavior disorder[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2016, 16(4): 228-234.
李旭东, 薛爽, 侯春蕾, 贾树红, 乔亚男, 周知, 魏坤, 郑文静, 荣培, 焦劲松. 特发性快速眼动睡眠期行为障碍经颅脑实质超声研究[J]. 中国现代神经疾病杂志, 2016, 16(4): 228-234.