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      REM Sleep Behavior Disorder (RBD) in Dementia with Lewy Bodies (DLB)

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          Abstract

          Rapid eye movement sleep behavior disorder (RBD) is a parasomnia, with abnormal dream-enacting behavior during the rapid eye movement (REM) sleep. RBD is either idiopathic or secondary to other neurologic disorders and medications. Dementia with Lewy bodies (DLB) is the third most common cause of dementia, and the typical clinical presentation is rapidly progressive cognitive impairment. RBD is one of the core features of DLB and may occur either in advance or simultaneously with the onset of DLB. The association between RBD with DLB is widely studied. Evidences suggest that both DLB and RBD are possibly caused by the shared underlying synucleinopathy. This review article discusses history, clinical manifestations, possible pathophysiologies, and treatment of DLB and RBD and provides the latest updates.

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          Stages in the development of Parkinson's disease-related pathology.

          Heiko Braak, Estifanos Ghebremedhin, Udo Rüb … (2004)
          The synucleinopathy, idiopathic Parkinson's disease, is a multisystem disorder that involves only a few predisposed nerve cell types in specific regions of the human nervous system. The intracerebral formation of abnormal proteinaceous Lewy bodies and Lewy neurites begins at defined induction sites and advances in a topographically predictable sequence. As the disease progresses, components of the autonomic, limbic, and somatomotor systems become particularly badly damaged. During presymptomatic stages 1-2, inclusion body pathology is confined to the medulla oblongata/pontine tegmentum and olfactory bulb/anterior olfactory nucleus. In stages 3-4, the substantia nigra and other nuclear grays of the midbrain and forebrain become the focus of initially slight and, then, severe pathological changes. At this point, most individuals probably cross the threshold to the symptomatic phase of the illness. In the end-stages 5-6, the process enters the mature neocortex, and the disease manifests itself in all of its clinical dimensions.
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            Clues to the functions of mammalian sleep.

            Jerome M Siegel (2005)
            The functions of mammalian sleep remain unclear. Most theories suggest a role for non-rapid eye movement (NREM) sleep in energy conservation and in nervous system recuperation. Theories of REM sleep have suggested a role for this state in periodic brain activation during sleep, in localized recuperative processes and in emotional regulation. Across mammals, the amount and nature of sleep are correlated with age, body size and ecological variables, such as whether the animals live in a terrestrial or an aquatic environment, their diet and the safety of their sleeping site. Sleep may be an efficient time for the completion of a number of functions, but variations in sleep expression indicate that these functions may differ across species.
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              Behavioral correlates of activity in identified hypocretin/orexin neurons.

              Boris Mileykovskiy, Lyudmila Kiyashchenko, Jerome M Siegel (2005)
              Micropipette recording with juxtacellular Neurobiotin ejection, linked micropipette-microwire recording, and antidromic and orthodromic activation from the ventral tegmental area and locus coeruleus were used to identify hypocretin (Hcrt) cells in anesthetized rats and develop criteria for identification of these cells in unanesthetized, unrestrained animals. We found that Hcrt cells have broad action potentials with elongated later positive deflections that distinguish them from adjacent antidromically identified cells. They are relatively inactive in quiet waking but are transiently activated during sensory stimulation. Hcrt cells are silent in slow wave sleep and tonic periods of REM sleep, with occasional burst discharge in phasic REM. Hcrt cells discharge in active waking and have moderate and approximately equal levels of activity during grooming and eating and maximal activity during exploratory behavior. Our findings suggest that these cells are activated during emotional and sensorimotor conditions similar to those that trigger cataplexy in narcoleptic animals.
              Article 0 comments Cited 180 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Dean Wu:
                ORCID: http://orcid.org/0000-0003-0147-1640
                Journal
                Journal ID (nlm-ta): Behav Neurol
                Journal ID (iso-abbrev): Behav Neurol
                Journal ID (publisher-id): BN
                Title: Behavioural Neurology
                Publisher: Hindawi
                ISSN (Print): 0953-4180
                ISSN (Electronic): 1875-8584
                Publication date Collection: 2018
                Publication date (Electronic): 19 June 2018
                Volume: 2018
                Electronic Location Identifier: 9421098
                Affiliations
                1Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
                2Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
                3Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
                4Sleep Center, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
                5Vertigo and Balance Impairment Center, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
                Author notes

                Academic Editor: Ying-Jui Ho

                Author information
                http://orcid.org/0000-0002-7714-0242
                http://orcid.org/0000-0002-4900-5967
                http://orcid.org/0000-0003-0147-1640
                Article
                DOI: 10.1155/2018/9421098
                PMC ID: 6029467
                PubMed ID: 30018672
                SO-VID: 9383bdbe-c68d-40f3-a9b5-6a4c2d59201d
                Copyright © Copyright © 2018 Po-Chi Chan et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 1 February 2018
                Date revision received : 30 March 2018
                Date accepted : 8 April 2018
                Funding
                Funded by: Taipei Medical University
                Award ID: TMU103-AE1-B33
                Categories
                Subject: Review Article

                Data availability:

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