Comparison Study of Polysomnographic Features in Multiple System Atrophy-cerebellar Types Combined with and without Rapid Eye Movement Sleep Behavior Disorder.
BACKGROUND
The brain stem is found to be impaired in multiple system atrophy-cerebellar types (MSA-C). Rapid eye movement (REM) sleep behavior disorder (RBD) is reported as a marker of progressive brain stem dysfunction. Few systematic studies about the sleep disturbances in MSA-C patients combined with or without RBD were reported. This study aimed to explore the polysomnographic (PSG) features of sleep disturbances between MSA-C patients with and without RBD.


METHODS
Totally, 46 MSA-C patients (23 with RBD, and 23 without RBD) were enrolled in this study. All patients underwent a structured interview for their demographic data, history of sleep pattern, and movement disorders; and then, overnight video-PSG was performed in each patient. All the records were evaluated by specialists at the Sleep Medicine Clinic for RBD and the Movement Disorder Clinic for MSA-C. The Student's t-test, Mann-Whitney U-test for continuous variables, and the Chi-square test for categorical variables were used in this study.


RESULTS
MSA-C patients with RBD had younger visiting age (52.6 ± 7.4 vs. 56.7 ± 6.0 years, P = 0.046) and shorter duration of the disease (12.0 [12.0, 24.0] vs. 24.0 [14.0, 36.0] months, P = 0.009) than MSA-C patients without RBD. MSA-C with RBD had shorter REM sleep latency (111.7 ± 48.2 vs. 157.0 ± 68.8 min, P = 0.042), higher percentage of REM sleep (14.9% ±4.0% vs. 10.0% ± 3.2%, P = 0.019), and lower Stage I (9.5% ±7.2% vs. 15.9% ±8.0%, P = 0.027) than MSA-C without RBD. Moreover, MSA-C patients with RBD had more decreased sleep efficiency (52.4% ±12.6% vs. 65.8% ±15.9%, P = 0.029) than that without RBD.


CONCLUSIONS
In addition to the RBD, MSA-C patients with RBD had other more severe sleep disturbances than those without RBD. The sleep disorders of MSA patients might be associated with the progress of the disease.
Department of Neurology, Xuanwu Hospital, Capital Medical University; Beijing Key Laboratory of Neuromodulation, Beijing 100053, China.
Yan
Y
Ding
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053; Department of Neurology, Beijing Geriatric Hospital, Beijing 100095, China.
Yue-Qing
YQ
Hu
Department of Neurology, Xuanwu Hospital, Capital Medical University; Beijing Key Laboratory of Neuromodulation, Beijing 100053, China.
Shu-Qin
SQ
Zhan
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Cun-Jiang
CJ
Li
Department of Neurology, Xuanwu Hospital, Capital Medical University; Beijing Key Laboratory of Neuromodulation, Beijing 100053, China.
Hong-Xing
HX
Wang
Department of Neurology, Xuanwu Hospital, Capital Medical University; Beijing Key Laboratory of Neuromodulation, Beijing 100053, China.
Yu-Ping
YP
Wang
D002524:Cerebellar Ataxia / Q000196:embryology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000503:physiopathology*; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000503:physiopathology*