REM sleep behavior disorder in patients with guadeloupean parkinsonism, a tauopathy.
OBJECTIVE
To describe sleep characteristics and rapid eye movement (REM) sleep behavior disorder in patients with Guadeloupean atypical parkinsonism (Gd-PSP), a tauopathy resembling progressive supranuclear palsy that mainly affects the midbrain. It is possibly caused by the ingestion of sour sop (corossol), a tropical fruit containing acetogenins, which are mitochondrial poisons.


METHODS
Sleep interview, motor and cognitive tests, and overnight videopolysomnography.


METHODS
Thirty-six age-, sex-, disease-duration- and disability-matched patients with Gd-PSP (n = 9), progressive supranuclear palsy (a tauopathy, n = 9), Parkinson disease (a synucleinopathy, n = 9) and controls (n = 9).


METHODS
Tertiary-care academic hospital.


RESULTS
REM sleep behavior disorder was found in 78% patients with Gd-PSP (43% of patients reported having this disorder several years before the onset of parkinsonism), 44% of patients with idiopathic Parkinson disease, 33% of patients with progressive supranuclear palsy, and no controls. The percentage of muscle activity during REM sleep was greater in patients with Gd-PSP than in controls (limb muscle activity, 8.3%+/-8.7% vs 0.1%+/- 0.2%; chin muscle activity, 24.3%+/- 23.7% vs 0.7%+/-2.0%) but similar to that of other patient groups. The latency and percentage of REM sleep were similar in patients with Gd-PSP, patients with Parkinson disease, and controls, whereas patients with progressive supranuclear palsy had delayed and shortened REM sleep.


CONCLUSIONS
Although Gd-PSP is a tauopathy, most patients experience REM sleep behavior disorder. This suggests that the location of neuronal loss or dysfunction in the midbrain, rather than the protein comprising the histologic lesions (synuclein versus tau aggregation), is responsible for suppressing muscle atonia during REM sleep. Subjects with idiopathic REM sleep behavior disorder should avoid eating sour sop.
De Cock
Valérie Cochen
VC
Service de Neurologie, Hôpital Saint-Antoine, Paris, France.
Lannuzel
Annie
A
Verhaeghe
Stéphane
S
Roze
Emmanuel
E
Ruberg
Merle
M
Derenne
Jean Philippe
JP
Willer
Jean Claude
JC
Vidailhet
Marie
M
Arnulf
Isabelle
I
D054378:Acetogenins; D000368:Aged; D003704:Dementia / Q000139:chemically induced / Q000175:diagnosis; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D004325:Dreams / Q000187:drug effects; D005233:Fatty Alcohols / Q000633:toxicity*; D005260:Female; D005638:Fruit / Q000633:toxicity*; D019430:Guadeloupe; D006801:Humans; D007783:Lactones / Q000633:toxicity*; D008297:Male; D008636:Mesencephalon / Q000187:drug effects; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000175:diagnosis; D020734:Parkinsonian Disorders / Q000139:chemically induced* / Q000175:diagnosis; D017286:Polysomnography / Q000187:drug effects; D011446:Prospective Studies; D020187:REM Sleep Behavior Disorder / Q000139:chemically induced* / Q000175:diagnosis; D020922:Sleep-Wake Transition Disorders / Q000139:chemically induced / Q000175:diagnosis; D013494:Supranuclear Palsy, Progressive / Q000139:chemically induced / Q000175:diagnosis; D024801:Tauopathies / Q000139:chemically induced* / Q000175:diagnosis
D054378:Acetogenins; D005233:Fatty Alcohols; D007783:Lactones
Neurology. 1997 Oct;49(4):999-1003
9339679
Nature. 2006 Jun 1;441(7093):589-94
16688184
Neurophysiol Clin. 1988 Jun;18(3):255-69
3398830
Lancet. 1999 Jul 24;354(9175):281-6
10440304
Sleep. 2006 Oct;29(10):1321-5
17068986
Sleep. 1991 Dec;14(6):540-5
1798888
Brain. 2002 Apr;125(Pt 4):801-11
11912113
Eur J Neurosci. 2004 Nov;20(9):2474-8
15525288
Arch Neurol. 2006 Feb;63(2):268-72
16476816
Arch Ital Biol. 1988 Oct;126(4):239-57
3058079
J Neurol Neurosurg Psychiatry. 1998 May;64(5):683-5
9598693
Neurology. 2000 Dec 12;55(11):1621-6
11113214
Brain. 2005 Nov;128(Pt 11):2535-45
16000335
Neurology. 2002 Aug 27;59(4):585-9
12196654
Brain. 2007 Mar;130(Pt 3):816-27
17303592
Ann Neurol. 2006 Jan;59(1):178-81
16278841
J Neurochem. 2005 Nov;95(4):930-9
16219024
Neuroscience. 2003;121(2):287-96
14521988
Neurology. 1996 Jul;47(1):1-9
8710059
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
Neurology. 1998 Aug;51(2):363-70
9710004
Mov Disord. 2003 Oct;18(10):1179-83
14534924
J Sleep Res. 1993 Sep;2(3):143-148
10607086
Neurology. 1992 Jul;42(7):1371-4
1620348
Ann Neurol. 1989 Jun;25(6):577-81
2742360
J Neurochem. 2004 Jan;88(1):63-9
14675150
Sleep. 1986 Jun;9(2):293-308
3505730
Neurology. 1996 Feb;46(2):388-93
8614500
Ann Neurol. 2004 Oct;56(4):599-603
15455441
Physiol Behav. 1979 May;22(5):979-89
228328
Mov Disord. 2002 Jan;17(1):84-90
11835443
Sleep. 2005 Mar;28(3):349-54
16173657
Lancet Neurol. 2006 Jul;5(7):572-7
16781987
Brain Res. 2005 May 3;1042(2):160-8
15854587