title: Comparison of the clinical features of rapid eye movement sleep behavior disorder in patients with Parkinson's disease and multiple system atrophy.
abstract: OBJECTIVE
  The aim of this study was to evaluate differences in the clinical presentation and polysomnographic characteristics of rapid eye movement sleep behavior disorder (RBD) between patients with Parkinson's disease (PD) and those with multiple system atrophy (MSA).
  
  
  METHODS
  We conducted clinical interviews examining RBD symptoms, including violent and non-violent behaviors, in 49 patients with PD and 16 patients with MSA (as well as their bed partners) and performed polysomnography on all subject patients.
  
  
  RESULTS
  Twenty-seven patients with PD (55.1%) and 11 patients with MSA (68.8%) had rapid eye movement sleep without atonia (RWA) on polysomnogram. The relative amounts of RWA were quite similar between the two groups. For most of the RWA-positive patients in both groups, RBD symptoms remained non-violent or silent. RBD symptoms in PD patients seemed to increase with the course of PD, while most of the RBD symptoms in the MSA patients occurred just prior to or at the onset of MSA and then disappeared within a short period.
  
  
  CONCLUSIONS
  Although PD and MSA frequently accompany RWA, RBD symptoms often remain non-violent or silent. Differences in the course of RBD symptoms in patients with PD and MSA may reflect the difference in the degeneration process of the two disorders.
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan. ntnomura@med.tottori-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Uemura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yasui
authors.forename: Taeko
authors.initials: T
authors.lastname: Sasai
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Namba
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000503:physiopathology*; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods; D020187:REM Sleep Behavior Disorder / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology