Periodic leg movements and REM sleep without atonia in Parkinson's disease with camptocormia

Authors

  • Sophie Lavault MSc,

    1. Unité des Pathologies du Sommeil, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
    2. UMR975 Inserm, and Université Paris 6, Paris, France
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  • Frederic Bloch MD,

    1. UMR975 Inserm, and Université Paris 6, Paris, France
    2. Centre d'Investigation Clinique – Fédération de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assitance Publique – Hôpitaux de Paris, Paris, France
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  • Jean-Luc Houeto MD, PhD,

    1. Centre d'Investigation Clinique – Fédération de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assitance Publique – Hôpitaux de Paris, Paris, France
    2. Service de Neurologie, Inserm CIC802, EA3808, Université de Poitiers, France
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  • Eric Konofal MD, PhD,

    1. Unité des Pathologies du Sommeil, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Marie-Laure Welter MD, PhD,

    1. UMR975 Inserm, and Université Paris 6, Paris, France
    2. Centre d'Investigation Clinique – Fédération de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assitance Publique – Hôpitaux de Paris, Paris, France
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  • Yves Agid MD, PhD,

    1. UMR975 Inserm, and Université Paris 6, Paris, France
    2. Centre d'Investigation Clinique – Fédération de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assitance Publique – Hôpitaux de Paris, Paris, France
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  • Isabelle Arnulf MD, PhD

    Corresponding author
    1. Unité des Pathologies du Sommeil, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
    2. UMR975 Inserm, and Université Paris 6, Paris, France
    • Unité des Pathologies du Sommeil -Hôpital Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
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  • Potential conflict of interest: All authors have no COI and no FD to make.

Abstract

Camptocormia (a flexion of the trunk that only appears when standing or walking) affects a minority of patients with Parkinson's disease (PD). As it responds poorly to levodopa and is associated with reduced midbrain and pons volume, it may result from non-dopaminergic, brainstem lesions. As several sleep abnormalities in PD also result from non-dopaminergic brainstem lesions, we monitored sleep in 24 non-demented PD patients with (n = 12) and without (n = 12) camptocormia and in 12 controls. Nearly half (42%) patients with camptocormia had abnormal periodic leg movement indices (>15/h), versus 17% patients without camptocormia and 8% of controls (p = 0.02). In addition, the percentage of enhanced muscle activity during REM sleep (measured on the chin and on the limb muscles) tended to be higher in patients with than without camptocormia (51 ± 39% vs. 20 ± 25%, p = 0.06). The other sleep and REM sleep characteristics (sleep and REM sleep onset latencies, sleep time and sleep stage percentages, REMs density, arousal, and apnea-hypopnea indices) were not different between these two PD groups. Lesions causing this axial dystonia may spare the sleep systems but affect the control of movements during sleep. © 2009 Movement Disorder Society

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