BACKGROUND AND PURPOSE: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia reflecting changes in the brain, but which specific neuronal networks are involved in human RBD pathogenesis has not yet been determined. To date, only one case of idiopathic RBD has undergone autopsy, in which "incidental Lewy body disease" was found. Due to the severe neuronal loss and gliosis in the substantia nigra (SN) and locus ceruleus (LC) in this case, degeneration of brainstem monoaminergic neurons was postulated as the underlying substrate for RBD. Additional cases of idiopathic RBD with neuropathologic examination may help clarify which key brainstem structures are involved. PATIENT AND METHODS: Case report with neuropathologic analysis. RESULTS: A man with polysomnographically proven RBD (onset age 57 years), but no other neurologic signs or symptoms, underwent neuropathologic examination upon his death at age 72. Histopathologic analysis showed Lewy body disease, but no significant neuronal loss or gliosis was present in the SN or LC. CONCLUSIONS: This case represents another example of Lewy body disease associated with RBD. The minimal degenerative changes in the SN and LC call into question the role of these nuclei in RBD, at least in our case. We suggest additional cases of idiopathic RBD undergo neuropathologic analyses to better delineate the neurologic substrate of this intriguing parasomnia.
BACKGROUND AND PURPOSE:Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia reflecting changes in the brain, but which specific neuronal networks are involved in human RBD pathogenesis has not yet been determined. To date, only one case of idiopathic RBD has undergone autopsy, in which "incidental Lewy body disease" was found. Due to the severe neuronal loss and gliosis in the substantia nigra (SN) and locus ceruleus (LC) in this case, degeneration of brainstem monoaminergic neurons was postulated as the underlying substrate for RBD. Additional cases of idiopathic RBD with neuropathologic examination may help clarify which key brainstem structures are involved. PATIENT AND METHODS: Case report with neuropathologic analysis. RESULTS: A man with polysomnographically proven RBD (onset age 57 years), but no other neurologic signs or symptoms, underwent neuropathologic examination upon his death at age 72. Histopathologic analysis showed Lewy body disease, but no significant neuronal loss or gliosis was present in the SN or LC. CONCLUSIONS: This case represents another example of Lewy body disease associated with RBD. The minimal degenerative changes in the SN and LC call into question the role of these nuclei in RBD, at least in our case. We suggest additional cases of idiopathic RBD undergo neuropathologic analyses to better delineate the neurologic substrate of this intriguing parasomnia.
Authors: Heiko Braak; Kelly Del Tredici; Udo Rüb; Rob A I de Vos; Ernst N H Jansen Steur; Eva Braak Journal: Neurobiol Aging Date: 2003 Mar-Apr Impact factor: 4.673
Authors: B F Boeve; M H Silber; J E Parisi; D W Dickson; T J Ferman; E E Benarroch; A M Schmeichel; G E Smith; R C Petersen; J E Ahlskog; J Y Matsumoto; D S Knopman; C H Schenck; M W Mahowald Journal: Neurology Date: 2003-07-08 Impact factor: 9.910
Authors: Roberta Frigerio; Hiroshige Fujishiro; Demetrius M Maraganore; Kevin J Klos; Anthony DelleDonne; Michael G Heckman; Julia E Crook; Keith A Josephs; Joseph E Parisi; Bradley F Boeve; Dennis W Dickson; J Eric Ahlskog Journal: Arch Neurol Date: 2009-09
Authors: Jennifer Molano; Bradley Boeve; Tanis Ferman; Glenn Smith; Joseph Parisi; Dennis Dickson; David Knopman; Neill Graff-Radford; Yonas Geda; John Lucas; Kejal Kantarci; Maria Shiung; Clifford Jack; Michael Silber; V Shane Pankratz; Ronald Petersen Journal: Brain Date: 2009-11-04 Impact factor: 13.501