Journal
YEAR IN NEUROLOGY 2
Volume 1184, Issue -, Pages 15-54Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1749-6632.2009.05115.x
Keywords
REM sleep behavior disorder; parasomnia; synucleinopathy; neurodegenerative disease
Categories
Funding
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [P01NS040256, P50NS040256] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG015866, U01AG006786, P50AG016574] Funding Source: NIH RePORTER
- NIA NIH HHS [P50 AG016574, R01 AG015866, R01 AG015866-09, U01 AG006786-14, P50 AG016574-01, U01 AG006786, AG 16574, AG 15866, AG 06786] Funding Source: Medline
- NINDS NIH HHS [P50 NS40256, P01 NS040256-05, P50 NS040256, P01 NS040256] Funding Source: Medline
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Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. The polysomnographic features of RBD include increased electromyographic tone +/- dream enactment behavior during REM sleep. Management with counseling and pharmacologic measures is usually straightforward and effective. In this review, the terminology, clinical and polysomnographic features, demographic and epidemiologic features, diagnostic criteria, differential diagnosis, and management strategies are discussed. Recent data on the suspected pathophysiologic mechanisms of R-BD are also reviewed. The literature and our institutional experience on RBD are next discussed, with an emphasis on the RBD-neurodegenerative disease association and particularly the RBD-synucleinopathy association. Several issues relating to evolving concepts, controversies, and future directions are then reviewed, with an emphasis on idiopathic RBD representing an early feature of a neurodegenerative disease and particularly an evolving synucleinopathy. Planning for future therapies that impact patients with idiopathic RBD is reviewed in detail.
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