@article{8112695f1e744896ad47a17337a099cf,
title = "Quantitative REM Sleep without Atonia in Parkinson's Disease and Essential Tremor",
abstract = "Background: Rapid eye movement (REM) sleep behavior disorder (RBD) occurs occasionally in essential tremor (ET), but polysomnographic REM sleep without atonia (RSWA) analyses have been sparse. Objective: To characterize the amount and distribution of polysomnographic RSWA, the electrophysiologic substrate of RBD, in patients with Parkinson's disease (PD) and ET. Methods: We analyzed quantitative RSWA in 73 patients: PD (23), ET (23), and age-sex-matched controls (27). None had dream-enactment behavior history or received antidepressants. Phasic, tonic, “any,” and phasic-burst duration RSWA measures were calculated in the submentalis (SM) and anterior tibialis (AT) muscles. The automated REM atonia index (RAI) was also determined. Statistical analysis was performed by Kruskal-Wallis rank-sum and Mann-Whitney tests. Results: SM phasic RSWA was significantly greater for PD than ET patients and controls (12.5% ± 12.8% vs. 4.9% ± 6.7%, 3.9% ± 2.6%), as was SM “any” (13.54% ± 14.30% vs. 5.2% ± 7.6%, 4.2% ± 2.6%). RAI was significantly lower in PD than in ET and controls (0.78 ± 0.23 vs. 0.92 ± 0.09 vs. 0.90 ± 0.17, P ≤ 0.005), but no different between ET and controls. AT phasic and “any” RSWA was similar between the 3 groups. ET and control RSWA was similar in all measures. Two ET patients (8.7%) had SM RSWA similar to PD patients. Conclusions: Elevated SM RSWA distinguished PD from ET in patients without dream-enactment symptoms and occurs frequently in PD patients, and in isolated tremor suggests underlying synucleinopathy. Prospective studies will further validate these findings.",
keywords = "REM sleep without atonia, RSWA, REM sleep, behavior disorder, RBD, essential tremor, diagnosis, polysomnography, PSG.",
author = "Gossard, {Thomas R.} and McCarter, {Stuart J.} and Evan Gorres and Feemster, {John C.} and Timm, {Paul C.} and Teigen, {Luke N.} and Ralston, {Christy L.} and Westerland, {Sarah M.} and Conway, {Jimmy P.} and Jagielski, {Jack T.} and Olson, {Carl D.} and Edgar, {Liam J.} and Veum, {Emma L.} and Rodolfo Savica and Boeve, {Brad F.} and Silber, {Michael H.} and {St. Louis}, {Erik K.}",
note = "Funding Information: The project described was supported by a Mayo Clinic Alzheimer's Disease Research Center Grant Award from the National Institute on Aging (P50 AG016574), and the National Center for Research Resources, and the National Center for Advancing Translational Sciences, NIH (1 UL1 RR024150‐01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors declare that there are no conflicts of interest relevant to this work. Funding Sources and Conflict of Interest: Funding Information: R.S. receives research support from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the Mayo Clinic Small Grants Program National Center for Advancing Translational Sciences (NCATS) and unrestricted research grant from Acadia Pharmaceutical, Inc. B.F.B. receives funding from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, the Lewy Body Dementia Association, GE Healthcare, Axovant Sciences, Inc., and Biogen. E.K.S. reports research support from the National Center for Research Resources, the National Center for Advancing Translational Sciences, and the National Institute on Aging. All other authors have no disclosures to report. Financial Disclosures for the Previous 12 Months: Publisher Copyright: {\textcopyright} 2020 International Parkinson and Movement Disorder Society",
year = "2021",
month = jan,
doi = "10.1002/mdc3.13112",
language = "English (US)",
volume = "8",
pages = "37--43",
journal = "Movement Disorders Clinical Practice",
issn = "2330-1619",
publisher = "John Wiley and Sons Ltd",
number = "1",
}