Young Eun Kim1, Hui June Yang2, Ji Young Yun3, Han-Joon Kim2, Jee-Young Lee4, Beom S Jeon5. 1. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi, Republic of Korea. 2. Department of Neurology and Movement Disorder center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea. 3. Department of Neurology, EwhaWomans University Mokdong Hospital, Seoul, Republic of Korea. 4. Department of Neurology, College of Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea. 5. Department of Neurology and Movement Disorder center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr.
Abstract
BACKGROUND: The anatomical substrates associated with generalized muscle atonia during REM sleep are located on the pontine tegmentum and medial medulla oblongata. We examined whether patients with REM sleep behavior disorder (RBD) have abnormal ocular movements suggesting brainstem or cerebellar dysfunction in Parkinson's disease (PD). METHODS: Cross-sectional survey for the existence of RBD and abnormal ocular movements. Ocular movements were examined by video-oculography (VOG). RESULTS: A total of 202 patients were included in this study. One hundred and sixteen (57.4%) of the 202 patients have clinically probable RBD, and 28 (24.1%) of the 116 with clinically probable RBD patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction; whereas 86 of the 202 patients did not have clinically probable RBD, and only 7 (8.1%) of the 86 patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction (P=0.001). CONCLUSION: This study suggests that the presence of RBD is associated with more severe or extensive brainstem pathology or different distribution of pathology in PD.
BACKGROUND: The anatomical substrates associated with generalized muscle atonia during REM sleep are located on the pontine tegmentum and medial medulla oblongata. We examined whether patients with REM sleep behavior disorder (RBD) have abnormal ocular movements suggesting brainstem or cerebellar dysfunction in Parkinson's disease (PD). METHODS: Cross-sectional survey for the existence of RBD and abnormal ocular movements. Ocular movements were examined by video-oculography (VOG). RESULTS: A total of 202 patients were included in this study. One hundred and sixteen (57.4%) of the 202 patients have clinically probable RBD, and 28 (24.1%) of the 116 with clinically probable RBD patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction; whereas 86 of the 202 patients did not have clinically probable RBD, and only 7 (8.1%) of the 86 patients had abnormal VOG findings suggesting brainstem or cerebellar dysfunction (P=0.001). CONCLUSION: This study suggests that the presence of RBD is associated with more severe or extensive brainstem pathology or different distribution of pathology in PD.