title: Rapid eye movement sleep behavior disorder in patients with probable Alzheimer's disease.
abstract: OBJECTIVE
  Rapid eye movement (REM) sleep behavior disorder (RBD) is commonly associated with neurodegenerative disorders characterized by α-synuclein deposition, including Parkinson's disease, multiple system atrophy, and Lewy body dementia. However, this tendency in tauopathy-mediated diseases is rare and only sporadically reported. We systematically illustrate the occurrence of RBD and sleep features among a cohort of patients with Alzheimer's disease (AD), a non-synucleinopathy.
  
  
  METHODS
  We recruited 105 clinically probable AD patients. Fifteen clinically probable AD patients with suspected RBD underwent a video-polysomnography (vPSG) examination.
  
  
  RESULTS
  Five patients with probable AD exhibited RBD. One of the patients performed repeated touching of the head and the face with his hands and flailed his arms. Three patients exhibited hand twisting, exploring, prominent limb kicking, and jerking. The fifth patient exhibited all of the characteristics of RBD (he recalled a dream about fighting animals), and his wife was awakened by his screaming. Of these five patients, one patient took the acetylcholinesterase inhibitor drug donepezil. The patients with AD + RBD demonstrated increases in both tonic and phasic electromyography activity during REM sleep, but sleep architecture did not differ between the AD + RBD and AD-alone groups.
  
  
  CONCLUSIONS
  RBD can occur in patients with AD. The occurrence of RBD does not change the sleep architecture of AD patients.
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.|Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Wang
authors.affiliation: Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, SAR, Hong Kong, China.
authors.forename: Yun Kwok
authors.initials: YK
authors.lastname: Wing
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
authors.forename: Jianli
authors.initials: J
authors.lastname: Xing
authors.affiliation: Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Hainan Branch of Chinese PLA General Hospital, Hainan, 572014, China.
authors.forename: Zengqiang
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Hongxiang
authors.initials: H
authors.lastname: Yao
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
authors.forename: Yan'e
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
authors.forename: Yanchang
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Department of Geriatric Neurology, Sleep Medicine Research Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. zhangxi@301hospital.com.cn.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D000818:Animals; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011336:Probability; D020187:REM Sleep Behavior Disorder / Q000453:epidemiology*; D012890:Sleep / Q000502:physiology; D012895:Sleep, REM / Q000502:physiology*
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Alzheimer’s disease; REM sleep behavior disorder; REM sleep without atonia; Video-polysomnography