title: Periodic leg movements and REM sleep without atonia in Parkinson's disease with camptocormia.
abstract: Camptocormia (a flexion of the trunk that only appears when standing or walking) affects a minority of patients with Parkinson's disease (PD). As it responds poorly to levodopa and is associated with reduced midbrain and pons volume, it may result from non-dopaminergic, brainstem lesions. As several sleep abnormalities in PD also result from non-dopaminergic brainstem lesions, we monitored sleep in 24 non-demented PD patients with (n = 12) and without (n = 12) camptocormia and in 12 controls. Nearly half (42%) patients with camptocormia had abnormal periodic leg movement indices (>15/h), versus 17% patients without camptocormia and 8% of controls (p = 0.02). In addition, the percentage of enhanced muscle activity during REM sleep (measured on the chin and on the limb muscles) tended to be higher in patients with than without camptocormia (51 +/- 39% vs. 20 +/- 25%, p = 0.06). The other sleep and REM sleep characteristics (sleep and REM sleep onset latencies, sleep time and sleep stage percentages, REMs density, arousal, and apnea-hypopnea indices) were not different between these two PD groups. Lesions causing this axial dystonia may spare the sleep systems but affect the control of movements during sleep.
authors.affiliation: Unité des Pathologies du Sommeil, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lavault
authors.forename: Frederic
authors.initials: F
authors.lastname: Bloch
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Houeto
authors.forename: Eric
authors.initials: E
authors.lastname: Konofal
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Welter
authors.forename: Yves
authors.initials: Y
authors.lastname: Agid
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D020189:Nocturnal Myoclonus Syndrome / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications*; D011187:Posture / Q000502:physiology; D020187:REM Sleep Behavior Disorder / Q000209:etiology*; D012894:Sleep Stages / Q000502:physiology; D016138:Walking / Q000502:physiology