BackgroundIn early‐stage Parkinson's disease (PD), rapid eye movement (REM) sleep behavior disorder (RBD) predicts poor cognitive and motor outcome. However, the baseline significance and disease evolution associated with isolated REM sleep without atonia (iRWA, ie, enhanced muscle tone during 8.7% of REM sleep, but no violent behavior) are not well understood.ObjectivesThe objective is to determine whether iRWA was a mild form of RBD and progressed similarly over time.MethodsParticipants with early PD (<4 years from medical diagnosis) were included from 2014 to 2021 in a longitudinal study. They underwent interviews and examinations in the motor, cognitive, autonomous, psychiatric, sensory, and sleep domains every year for 4 years along with a video polysomnography and magnetic resonance imaging examination of the locus coeruleus/subcoeruleus complex (LC/LsC) at baseline. The clinical characteristics were compared between groups with normal REM sleep, with iRWA and with RBD, at baseline and for 4 years.ResultsAmong 159 PD participants, 25% had RBD, 25% had iRWA, and 50% had normal REM sleep. At baseline, the non‐motor symptoms were less prevalent and the LC/LsC signal intensity was more intense in participants with iRWA than with RBD. Over 4 years, participants with normal REM sleep and with iRWA had a similar cognitive and motor trajectory, whereas participants with RBD had greater cognitive and motor decline.ConclusionsWe demonstrated that iRWA is frequent in early PD, but is not a milder form of RBD. Both groups have distinct baseline characteristics and clinical trajectories. They should be distinguished in clinical routine and research protocols. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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没有失张力的孤立快速眼动睡眠并不等同于早期帕金森病的快速眼动睡眠行为障碍

背景在早期帕金森病 (PD) 中，快速眼动 (REM) 睡眠行为障碍 (RBD) 预示着认知和运动结果不佳。然而，与无乏力的孤立快速眼动睡眠（iRWA，即在 8.7% 的快速眼动睡眠期间肌张力增强，但没有暴力行为）相关的基线意义和疾病演变尚不清楚。 目的 目的是确定 iRWA 是否是一种轻度的方法 2014 年至 2021 年期间，患有早期 PD（医学诊断后 <4 年）的参与者被纳入一项纵向研究中。他们在 4 年内每年接受运动、认知、自主、精神、感觉和睡眠领域的访谈和检查，并在基线时对蓝斑/蓝斑下复合体 (LC/LsC) 进行视频多导睡眠图和磁共振成像检查。在基线和 4 年期间比较正常 REM 睡眠组、iRWA 组和 RBD 组之间的临床特征。 结果 在 159 名 PD 参与者中，25% 具有 RBD，25% 具有 iRWA，50% 具有正常 REM 睡眠。在基线时，iRWA 参与者的非运动症状较 RBD 参与者少见，并且 LC/LsC 信号强度更强。 4 年多来，正常 REM 睡眠和 iRWA 的参与者具有相似的认知和运动轨迹，而 RBD 参与者的认知和运动下降幅度更大。结论我们证明 iRWA 在早期 PD 中很常见，但不是 RBD 的较温和形式。两组都有不同的基线特征和临床轨迹。应在临床常规和研究方案中区分它们。 © 2024 作者。运动障碍由 Wiley periodicals LLC 代表国际帕金森和运动障碍协会出版。