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REM sleep behavior disorder in narcolepsy: A secondary form or an intrinsic feature?
Sleep Medicine Reviews ( IF 11.2 ) Pub Date : 2019-12-19 , DOI: 10.1016/j.smrv.2019.101254
Elena Antelmi 1 , Fabio Pizza 1 , Christian Franceschini 2 , Raffaele Ferri 3 , Giuseppe Plazzi 1
Affiliation  

Disrupted nighttime sleep is one of the pentad of symptoms defining Narcolepsy. REM sleep behavior disorder (RBD) largely contributes to night sleep disruption and narcolepsy is the most common cause of secondary RBD. However, RBD linked to narcolepsy (N-RBD) has been insufficiently characterized, leaving unsolved a number of issues. Indeed, it is still debated whether N-RBD is an intrinsic feature of narcolepsy, as indubitable for cataplexy, and therefore strictly linked to the cerebrospinal fluid hypocretin-1 (CSF hcrt-1) deficiency, or an associated feature, with a still unclear pathophysiology. The current review aims at rendering a comprehensive state–of-the-art of N-RBD, highlighting the open and unsettled topics. RBD reportedly affects 30–60% of patients with Narcolepsy type 1 (NT1), but it may be seen also in Narcolepsy type 2 (NT2). When compared to idiopathic/isolated RBD (iRBD), N-RBD has been reported to be characterized by less energetic and quieter episode, which however occur with the same probability in the first and the second part of the night and sometime even subcontinuously. N-RBD patients are generally younger than those with iRBD. N-RBD has been putatively linked to wake-sleep instability due to CSF hcrt-1 deficiency, but this latter by itself cannot explain completely the phenomenon as N-RBD has not been universally linked to low CSF hcrt-1 levels and it may be observed also in NT2. Therefore, other factors may probably play a role and further studies are needed to clarify this issue. In addition, therapeutic options have been poorly investigated.



中文翻译:

发作性睡病中的REM睡眠行为障碍:次要形式还是内在特征?

夜间睡眠中断是定义发作性睡病的症状之一。REM睡眠行为障碍(RBD)在很大程度上导致夜间睡眠中断,而发作性睡病是继发性RBD的最常见原因。但是,与发作性睡病(N-RBD)相关的RBD的特征尚不充分,尚有许多问题尚未解决。的确,仍存在争议,N-RBD是发作性睡病的固有特征,因为难免发生脑瘫,因此是否与脑脊髓液hycrecretin-1(CSF hcrt-1)缺乏症或相关特征密切相关,目前尚不清楚病理生理学。当前的审查旨在提供全面的N-RBD技术,重点介绍开放和尚未解决的主题。据报道,RBD会影响30%至60%的发作性睡病1型(NT1)患者,但也可能在发作性睡病2型(NT2)中见到。与特发性/孤立性RBD(iRBD)相比,据报道N-RBD的特点是精力充沛且安静,但在夜间的第一部分和第二部分发生的可能性相同,甚至有时是连续发生的。N-RBD患者通常比iRBD患者年轻。N-RBD可能与CSF hcrt-1缺乏引起的觉醒不稳定有关,但后者本身不能完全解释这一现象,因为N-RBD尚未普遍与CSF hcrt-1的低水平相关,可能是在NT2中也观察到。因此,其他因素可能也可能起一定作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。据报道,N-RBD的特征是精力充沛,安静些,但在夜晚的第一部分和第二部分发生的可能性相同,甚至有时是连续发生的。N-RBD患者通常比iRBD患者年轻。N-RBD可能与CSF hcrt-1缺乏引起的觉醒不稳定有关,但后者本身不能完全解释这一现象,因为N-RBD尚未普遍与CSF hcrt-1的低水平相关,可能是在NT2中也观察到。因此,其他因素可能也可能起一定作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。据报道,N-RBD的特征是精力充沛,安静些,但在夜间的第一部分和第二部分发生的可能性相同,甚至有时是连续发生的。N-RBD患者通常比iRBD患者年轻。N-RBD可能与CSF hcrt-1缺乏引起的觉醒不稳定有关,但后者本身不能完全解释这一现象,因为N-RBD尚未普遍与CSF hcrt-1的低水平相关,可能是在NT2中也观察到。因此,其他因素可能也可能起一定作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。N-RBD患者通常比iRBD患者年轻。N-RBD可能与CSF hcrt-1缺乏引起的觉醒不稳定有关,但后者本身不能完全解释这一现象,因为N-RBD尚未普遍与CSF hcrt-1的低水平相关,可能是在NT2中也观察到。因此,其他因素可能也可能起一定作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。N-RBD患者通常比iRBD患者年轻。N-RBD可能与CSF hcrt-1缺乏引起的觉醒不稳定有关,但后者本身不能完全解释这一现象,因为N-RBD尚未普遍与CSF hcrt-1的低水平相关,可能是在NT2中也观察到。因此,其他因素可能也可能起一定作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。其他因素可能也可能起作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。其他因素可能也可能起作用,需要进一步研究来澄清这个问题。另外,对治疗选择的研究还很差。

更新日期:2019-12-19
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