快速眼球运动睡眠期行为障碍(rapid-eye movement sleep behavior disorder,RBD)不仅是一种睡眠障碍疾病,而且与帕金森病(Parkinson’s disease,PD)、路易体痴呆(dementia with Lewy bodies,DLB)、多系统萎缩(multiple system atrophy,M...快速眼球运动睡眠期行为障碍(rapid-eye movement sleep behavior disorder,RBD)不仅是一种睡眠障碍疾病,而且与帕金森病(Parkinson’s disease,PD)、路易体痴呆(dementia with Lewy bodies,DLB)、多系统萎缩(multiple system atrophy,MSA)等α-突触核蛋白病密切相关,通常被认为是这些疾病的早期预警。研究表明,RBD可在α-突触核蛋白病症状发作前数年至数十年出现,并预测神经变性病和认知功能障碍。本文就RBD的流行病学、临床特征及疾病进展等进行综述,进一步了解RBD与α-突触核蛋白病的关系,为临床早期诊断提供帮助。展开更多
目的 :研究2017年新版路易体痴呆(dementia with Lewy bodies,DLB)指南的诊断要点、治疗、预后等,以期提高医师对DLB的关注和认识,使更多的DLB患者得到早期诊断、全程管理及综合治疗。方法:选取30例符合2005年DLB诊断标准的很可能的DLB...目的 :研究2017年新版路易体痴呆(dementia with Lewy bodies,DLB)指南的诊断要点、治疗、预后等,以期提高医师对DLB的关注和认识,使更多的DLB患者得到早期诊断、全程管理及综合治疗。方法:选取30例符合2005年DLB诊断标准的很可能的DLB患者,回顾性分析其临床特点、治疗等,并用2017年新版DLB诊断标准对其进行诊断。结果:根据2017年新版DLB诊断标准,30例患者中有27例被诊断为很可能的DLB,3例被诊断为可能的DLB;其中伴有帕金森症患者29例(96.7%),波动性认知障碍的患者有16例(53.3%);视幻觉患者25例(83.3%);伴快速眼动期睡眠行为障碍(rapid eye movement sleep behavior disorder,RBD)症状患者11例(36.7%)。21例患者(70%)以帕金森症起病,有9例患者(30%)以认知障碍伴视幻觉起病。结论:2017新版诊断标准增加了快速眼动期睡眠行为障碍(多导睡眠图异常)及123I-间位碘代苄胍心肌闪烁扫描成像异常对于诊断路易体的权重,为早期识别和诊断路易体痴呆提供客观依据,有利于患者得到及时的管理及综合治疗,从而改善其预后。展开更多
路易体痴呆(dementia with Lewy bodies,DLB)是仅次于阿尔茨海默病(AD)的常见老年痴呆类型,但其病因、发病机制目前尚不清楚。DLB患者的临床表现各异,容易因认知功能障碍、幻觉及帕金森样症状等被误诊误治。且多数患者存在对神经安定药...路易体痴呆(dementia with Lewy bodies,DLB)是仅次于阿尔茨海默病(AD)的常见老年痴呆类型,但其病因、发病机制目前尚不清楚。DLB患者的临床表现各异,容易因认知功能障碍、幻觉及帕金森样症状等被误诊误治。且多数患者存在对神经安定药的高敏感性,因此临床医生应了解DLB的临床表现及诊治进展,提高对DLB的认识并引起重视,及早为DLB患者制定个体化的诊疗方案。展开更多
Objective： Rapid eye movement sleep behavior disorder （RBD） is characterized by dream enactment and loss of muscle atonia during rapid eye movement sleep. RBD is closely related to α-synucleinopathies including Pa...Objective： Rapid eye movement sleep behavior disorder （RBD） is characterized by dream enactment and loss of muscle atonia during rapid eye movement sleep. RBD is closely related to α-synucleinopathies including Parkinson＇s disease, dementia with Lewy bodies, and multiple system atrophy. Many studies have investigated the markers of imaging and neurophysiological, genetic, cognitive, autonomic function of RBD and their predictive value for neurodegenerative diseases. This report reviewed the progress of these studies and discussed their limitations and future research directions. Data Sources： Using the combined keywords： ＂RBD＂, ＂neurodegenerative disease＂, ＂Parkinson disease＂, and ＂magnetic resonance imaging＂, the PubMed/MEDLINE literature search was conducted up to January 1, 2018. Study Selection： A total of 150 published articles were initially identified citations. Of the 150 articles, 92 articles were selected after further detailed review. This study referred to all the important English literature in full. Results： Single-nucleotide polymorphisms in SCARB2 （rs6812193） and MAPT （rs12185268） were significantly associated with RBD. The olfactory loss, autonomic dysfunction, marked electroencephalogram slowing during both wakefulness and rapid eye movement sleep, and cognitive impairments were potential predictive markers for RBD conversion to neurodegenerative diseases. Traditional structural imaging studies reported relatively inconsistent results, whereas reduced functional connectivity between the left putamen and substantia nigra and dopamine transporter uptake demonstrated by functional imaging techniques were relatively consistent findings. Conclusions： More longitudinal studies should be conducted to evaluate the predictive value of biomarkers of RBD. Moreover, because the glucose and dopamine metabolisms are not specific for assessing cognitive cognition, the molecular metabolism directly related to cognition should be investigated. There is a need for more t展开更多
文摘快速眼球运动睡眠期行为障碍(rapid-eye movement sleep behavior disorder,RBD)不仅是一种睡眠障碍疾病,而且与帕金森病(Parkinson’s disease,PD)、路易体痴呆(dementia with Lewy bodies,DLB)、多系统萎缩(multiple system atrophy,MSA)等α-突触核蛋白病密切相关,通常被认为是这些疾病的早期预警。研究表明,RBD可在α-突触核蛋白病症状发作前数年至数十年出现,并预测神经变性病和认知功能障碍。本文就RBD的流行病学、临床特征及疾病进展等进行综述,进一步了解RBD与α-突触核蛋白病的关系,为临床早期诊断提供帮助。
文摘目的 :研究2017年新版路易体痴呆(dementia with Lewy bodies,DLB)指南的诊断要点、治疗、预后等,以期提高医师对DLB的关注和认识,使更多的DLB患者得到早期诊断、全程管理及综合治疗。方法:选取30例符合2005年DLB诊断标准的很可能的DLB患者,回顾性分析其临床特点、治疗等,并用2017年新版DLB诊断标准对其进行诊断。结果:根据2017年新版DLB诊断标准,30例患者中有27例被诊断为很可能的DLB,3例被诊断为可能的DLB;其中伴有帕金森症患者29例(96.7%),波动性认知障碍的患者有16例(53.3%);视幻觉患者25例(83.3%);伴快速眼动期睡眠行为障碍(rapid eye movement sleep behavior disorder,RBD)症状患者11例(36.7%)。21例患者(70%)以帕金森症起病,有9例患者(30%)以认知障碍伴视幻觉起病。结论:2017新版诊断标准增加了快速眼动期睡眠行为障碍(多导睡眠图异常)及123I-间位碘代苄胍心肌闪烁扫描成像异常对于诊断路易体的权重,为早期识别和诊断路易体痴呆提供客观依据,有利于患者得到及时的管理及综合治疗,从而改善其预后。
文摘路易体痴呆(dementia with Lewy bodies,DLB)是仅次于阿尔茨海默病(AD)的常见老年痴呆类型,但其病因、发病机制目前尚不清楚。DLB患者的临床表现各异,容易因认知功能障碍、幻觉及帕金森样症状等被误诊误治。且多数患者存在对神经安定药的高敏感性,因此临床医生应了解DLB的临床表现及诊治进展,提高对DLB的认识并引起重视,及早为DLB患者制定个体化的诊疗方案。
文摘Objective： Rapid eye movement sleep behavior disorder （RBD） is characterized by dream enactment and loss of muscle atonia during rapid eye movement sleep. RBD is closely related to α-synucleinopathies including Parkinson＇s disease, dementia with Lewy bodies, and multiple system atrophy. Many studies have investigated the markers of imaging and neurophysiological, genetic, cognitive, autonomic function of RBD and their predictive value for neurodegenerative diseases. This report reviewed the progress of these studies and discussed their limitations and future research directions. Data Sources： Using the combined keywords： ＂RBD＂, ＂neurodegenerative disease＂, ＂Parkinson disease＂, and ＂magnetic resonance imaging＂, the PubMed/MEDLINE literature search was conducted up to January 1, 2018. Study Selection： A total of 150 published articles were initially identified citations. Of the 150 articles, 92 articles were selected after further detailed review. This study referred to all the important English literature in full. Results： Single-nucleotide polymorphisms in SCARB2 （rs6812193） and MAPT （rs12185268） were significantly associated with RBD. The olfactory loss, autonomic dysfunction, marked electroencephalogram slowing during both wakefulness and rapid eye movement sleep, and cognitive impairments were potential predictive markers for RBD conversion to neurodegenerative diseases. Traditional structural imaging studies reported relatively inconsistent results, whereas reduced functional connectivity between the left putamen and substantia nigra and dopamine transporter uptake demonstrated by functional imaging techniques were relatively consistent findings. Conclusions： More longitudinal studies should be conducted to evaluate the predictive value of biomarkers of RBD. Moreover, because the glucose and dopamine metabolisms are not specific for assessing cognitive cognition, the molecular metabolism directly related to cognition should be investigated. There is a need for more t
