title: Not Only Sleepwalking But NREM Parasomnia Irrespective of the Type Is Associated with HLA DQB1*05:01.
abstract: OBJECTIVE
  Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only.
  
  
  METHODS
  We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia gathered from four neurological sleep centers. Parasomniac events were classified according to ICSD-2 criteria. HLA DQB1 genotyping was compared to regional-matched reference allele-frequencies.
  
  
  RESULTS
  Fifty-six patients had more than 2 different parasomnia type: 11 sleepwalking, 4 sleep terrors, 3 confusional arousals only. Parasomniac events were documented during video-polysomnography (V-PSG) in 70% (49/70) of subjects (71.4% confusional arousals, 8.2% sleep terrors, 4.1% sleepwalking, 16.3% ≥ 2 NREM parasomnia types). Violent behavior during V-PSG occurred in 8.5% (6/71). NREM parasomnia onset was reported after the age of 30 years in 6.8% (5/74). The HLA DQB1*05:01 allele was present in 41% (29/71) compared to 24.2% in the regional-matched reference allele group (p < 0.05). This haplotype prevalence did not differ within the NREM parasomnia type. Epworth Sleepiness Score was 10 or higher in 28.6%.
  
  
  CONCLUSIONS
  This is a large polysomnography-based case series of patients with NREM parasomnia. In patients with suspected sleepwalking or sleep terrors, polysomnography is highly useful in detecting arousals from NREM sleep as a marker of NREM parasomnia. We confirmed previous findings by demonstrating a high prevalence of the HLA DQB1*05:01 genotype for different types of NREM parasomnias. Our findings therefore support a common genetic background, and corroborate the importance of video-polysomnography in the work-up of parasomnia.
authors.affiliation: Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.|Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Heidbreder
authors.affiliation: Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Frauscher
authors.affiliation: Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mitterling
authors.affiliation: Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Boentert
authors.affiliation: Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Schirmacher
authors.affiliation: Central Institute for Blood-Transfusion and Immunology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Paul
authors.initials: P
authors.lastname: Hörtnagl
authors.affiliation: Central Institute for Blood-Transfusion and Immunology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Schennach
authors.affiliation: Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Massoth
authors.affiliation: Department of Neurology, Clinic Maria Frieden Telgte, Telgte, Germany and University of Göttingen, Göttingen, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Happe
authors.affiliation: Hephata-Klinik Schwalmstadt-Treysa, Schwalmstadt- Treysa, Germany and Philipps University Marburg, Department of Neurology, Marburg, Germany.
authors.forename: Geert
authors.initials: G
authors.lastname: Mayer
authors.affiliation: Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Young
authors.affiliation: Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D059866:HLA-DQ beta-Chains / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020447:Parasomnias / Q000235:genetics*; D012189:Retrospective Studies; D020921:Sleep Arousal Disorders / Q000235:genetics; D012894:Sleep Stages; D013009:Somnambulism / Q000235:genetics; D014743:Videotape Recording; D055815:Young Adult
chemical_list: D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen
keywords: behavior; genetics; genotype; somnambulism; video-polysomnography