title: Clinical correlates of rapid eye movement sleep without atonia in Parkinson's disease.
abstract: OBJECTIVE
  The aim of the present study was to investigate the relationship between rapid eye movement (REM) sleep without atonia (RWA) and Parkinson's disease (PD) progression.
  
  
  METHODS
  We quantified tonic and phasic RWA by performing polysomnography in 198 PD patients. We then correlated the extent of RWA with clinical patient characteristics.
  
  
  RESULTS
  PD patients were categorized into quartiles of tonic and phasic RWA. We found that patients with more RWA tended to be older and have longer PD duration, a greater likelihood of REM sleep behavior disorder (RBD), more advanced Hoehn & Yahr (H&Y) stage, a higher dose of parkinsonian medication, poorer cognitive performance, worse quality of life, and more severe sleep disturbance. After adjusting for age, sex, and PD duration, patients in the highest two RWA quartile were more likely to have severe PD (H&Y stage ⩾ 3.0) than those in the lowest RWA quartile.
  
  
  CONCLUSIONS
  These findings provide evidence that RWA, especially with regard to tonic muscle activity, is associated with PD severity.
  
  
  CONCLUSIONS
  Further studies are warranted to determine the importance and utility of assessing RWA to evaluate sleep in PD patients.
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Kang-Ping
authors.initials: KP
authors.lastname: Xiong
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Cheng-Jie
authors.initials: CJ
authors.lastname: Mao
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Pei-Cheng
authors.initials: PC
authors.lastname: He
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Jun-Ying
authors.initials: JY
authors.lastname: Huang
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Dai
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Luo
authors.affiliation: Department of Neurology, Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases and The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215004, China; Institute of Neuroscience, Soochow University, Suzhou 215123, China. Electronic address: liucf@suda.edu.cn.
authors.forename: Chun-Feng
authors.initials: CF
authors.lastname: Liu
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009123:Muscle Hypotonia; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods; D011788:Quality of Life; D020187:REM Sleep Behavior Disorder / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology; D013997:Time Factors
keywords: Muscle atonia; Parkinson’s disease; Polysomnography; Rapid eye movement sleep