title: REM sleep behavior disorder in patients with guadeloupean parkinsonism, a tauopathy.
abstract: 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.
authors: Service de Neurologie, Hôpital Saint-Antoine, Paris, France.
authors: Valérie Cochen
authors: VC
authors: De Cock
authors: Annie
authors: A
authors: Lannuzel
authors: Stéphane
authors: S
authors: Verhaeghe
authors: Emmanuel
authors: E
authors: Roze
authors: Merle
authors: M
authors: Ruberg
authors: Jean Philippe
authors: JP
authors: Derenne
authors: Jean Claude
authors: JC
authors: Willer
authors: Marie
authors: M
authors: Vidailhet
authors: Isabelle
authors: I
authors: Arnulf
mesh_terms: 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
chemical_list: D054378:Acetogenins; D005233:Fatty Alcohols; D007783:Lactones
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