REM sleep behavior disorder in Parkinson disease: association with abnormal ocular motor findings.
BACKGROUND
The anatomical substrates associated with generalized muscle atonia during REM sleep are located on the pontine tegmentum and medial medulla oblongata. We examined whether patients with REM sleep behavior disorder (RBD) have abnormal ocular movements suggesting brainstem or cerebellar dysfunction in Parkinson's disease (PD).


METHODS
Cross-sectional survey for the existence of RBD and abnormal ocular movements. Ocular movements were examined by video-oculography (VOG).


RESULTS
A total of 202 patients were included in this study. One hundred and sixteen (57.4%) of the 202 patients have clinically probable RBD, and 28 (24.1%) of the 116 with clinically probable RBD patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction; whereas 86 of the 202 patients did not have clinically probable RBD, and only 7 (8.1%) of the 86 patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction (P=0.001).


CONCLUSIONS
This study suggests that the presence of RBD is associated with more severe or extensive brainstem pathology or different distribution of pathology in PD.
Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi, Republic of Korea.
Young Eun
YE
Kim
Department of Neurology and Movement Disorder center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea.
Hui June
HJ
Yang
Department of Neurology, EwhaWomans University Mokdong Hospital, Seoul, Republic of Korea.
Ji Young
JY
Yun
Department of Neurology and Movement Disorder center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea.
Han-Joon
HJ
Kim
Department of Neurology, College of Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
Jee-Young
JY
Lee
Department of Neurology and Movement Disorder center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr.
Beom S
BS
Jeon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D020187:REM Sleep Behavior Disorder / Q000209:etiology* / Q000503:physiopathology*
Downbeat nystagmus; Ocular motor abnormality; Parkinson disease; REM sleep behavior disorder; Video-oculography