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REM-Schlaf-Verhaltensstörung als prodromales Stadium von α-Synukleinopathien

Klinik, Epidemiologie, Pathophysiologie, Diagnose und Behandlung

REM sleep behavior disorder as a prodromal stage of α-synucleinopathies

Symptoms, epidemiology, pathophysiology, diagnosis and therapy

Zusammenfassung

Die REM(„rapid eye movement”)-Schlaf-Verhaltensstörung („REM sleep behavior disorder“, RBD) ist definiert als eine Parasomnie, die einerseits durch einen intermittierenden, elektromyographisch nachweisbaren Verlust der REM-Schlaf-assoziierten Atonie und andererseits durch das Auftreten ausgeprägter motorischer Aktivität während des Träumens (in der Regel mit aggressivem Inhalt) charakterisiert ist. Epidemiologische Daten über die Prävalenz von RBD sind wenig aussagekräftig. Die RBD kann idiopathisch oder symptomatisch sein. Für ihre Diagnose ist eine Video-Audio-Polysomnographie essenziell. Pharmakologisch stehen für ihre Behandlung hauptsächlich Clonazepam und Melatonin zur Verfügung. Aktuelle Studien belegen, dass Betroffene mit einer idiopathischen RBD ein auf bis zu 80 % erhöhtes spezifisches Risiko haben, in 10 bis 20 Jahren eine neurodegenerative Erkrankung vom α-Synukleinopathie-Typ (Parkinson-Krankheit, Demenz vom Lewy-Körper-Typ, Multisystematrophie) zu entwickeln. Die vorliegende Arbeit liefert eine kurze Übersicht über die Klinik, Epidemiologie, Pathophysiologie, Diagnose und Therapie der RBD.

Summary

Rapid eye movement (REM) sleep behavior disorder (RBD) is defined as a parasomnia characterized by loss of REM sleep-associated atonia and the presence of motor activity during dreaming typically presenting with an aggressive dream content. Epidemiological data on the prevalence of RBD are insufficient but it can be idiopathic or symptomatic. A video-audio polysomnography is essential for diagnosis. Clonazepam and melatonin are available as pharmaceutical treatment. Recent studies demonstrated that individuals suffering from idiopathic RBD carry a high specific risk (up to 80 %) for developing a neurodegenerative disorder of the α-synucleinopathy type (e.g. Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy) within 10–20 years. The current article provides a short overview of symptoms, epidemiology, pathophysiology, diagnosis and therapy of RBD.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. W.H. Oertel, C. Depboylu, M. Krenzer, D. Vadasz, V. Ries, F. Sixel-Döring und G. Mayer: keine Angaben

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Correspondence to W.H. Oertel.

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Oertel, W., Depboylu, C., Krenzer, M. et al. REM-Schlaf-Verhaltensstörung als prodromales Stadium von α-Synukleinopathien. Nervenarzt 85, 19–25 (2014). https://doi.org/10.1007/s00115-013-3891-8

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  • DOI: https://doi.org/10.1007/s00115-013-3891-8

Schlüsselwörter

  • REM-Schlaf-Verhaltensstörung
  • Parkinson-Krankheit
  • Prodromal
  • Alpha-Synukleinopathien
  • Video-Audio-Polysomnographie

Keywords

  • REM sleep behavior disorder
  • Parkinson disease
  • Prodromal
  • Alpha-synucleinopathies
  • Video-audio polysomnography