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A motor signature of REM sleep behavior disorder§

Authors

  • Delphine Oudiette PhD,

    1. Sleep Disorders Unit, Pitié-Salpêtrière Hospital, APHP, Paris, France
    2. INSERM U975
    3. Pierre et Marie Curie University, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epiniere, UMR-S975, Paris, France
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  • Smaranda Leu-Semenescu MD,

    1. Sleep Disorders Unit, Pitié-Salpêtrière Hospital, APHP, Paris, France
    2. INSERM U975
    3. Pierre et Marie Curie University, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epiniere, UMR-S975, Paris, France
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  • Emmanuel Roze MD, PhD,

    1. INSERM U975
    2. Pierre et Marie Curie University, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epiniere, UMR-S975, Paris, France
    3. Movement Disorders Unit, Neurology Department, Pitié-Salpêtrière Hospital, APHP, Paris, France
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  • Marie Vidailhet MD, PhD,

    1. INSERM U975
    2. Pierre et Marie Curie University, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epiniere, UMR-S975, Paris, France
    3. Movement Disorders Unit, Neurology Department, Pitié-Salpêtrière Hospital, APHP, Paris, France
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  • Valérie Cochen De Cock MD, PhD,

    1. Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui de Chauliac, INSERM U888, Montpellier, France
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  • Jean-Louis Golmard MD, PhD,

    1. Department of Biostatistics, Pitié–Salpêtrière Hospital, ER4, Pierre and Marie Curie University, Paris, France
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  • Isabelle Arnulf MD, PhD

    Corresponding author
    1. Sleep Disorders Unit, Pitié-Salpêtrière Hospital, APHP, Paris, France
    2. INSERM U975
    3. Pierre et Marie Curie University, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epiniere, UMR-S975, 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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  • Funding agencies: This study was funded by the Federation pour la Recherche sur le Cerveau (to I.A.), France Parkinson, and the Société Française de Recherche et de Médecine du Sommeil (to D.O.).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

The purpose of this study was to determine if there was a common pattern in movements during REM sleep behavior disorder (RBD).

Methods:

We blindly compared video-monitored movements during RBD (n = 136 clips) and wakefulness/arousal (n = 53 clips) in patients with Parkinson's disease (n = 29) and without parkinsonism (idiopathic RBD, n = 31; narcolepsy, n = 5).

Results:

The scorers accurately guessed the sleep/wake stage of 94% of video clips. Compared with wake movements, RBD movements were faster and more often repeated, jerky, and pseudohallucinatory, not self-centered, never associated with tremor, and rarely involved the environment in an appropriate manner. A specific posture of the hand (limp wrist with flexed digits) during grasping movements was evidenced during RBD in 48% of patients, reminiscent of hand-babbling in babies.

Conclusions:

These characteristics of movements were found in the 3 conditions (Parkinson's disease, idiopathic RBD, and primary narcolepsy), delineating a common motor signature of RBD. © 2011 Movement Disorder Society

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