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NEUROLOGY 1992;42:1371
© 1992 American Academy of Neurology

Polysomnographic features of REM sleep behavior disorder

Development of a scoring method

Odile Lapierre, MD and Jacques Montplaisir, MD, PhD

Centre d'étude du sommeil, Hôpital du Sacré-Coeur, and the Départemrnt de psychiatrie, Université de Montréal, PQ, Canada.

REM sleep behavior disorder (RBD) is characterized by the intermittent absence of REM sleep EMG atonia and the appearance of elaborate motor activity associated with dream mentation. There are no specific diagnostic criteria for RBD based upon polysomnographic findings. We describe a new scoring method and show its sensitivity to treatment with clonazepam. An increased phasic submental EMG density occurs in RBD patients, but REM density is similar to that of controls. Clonazepam selectively decreases REM sleep phasic activity but exerts no effect on REM sleep atonia. Periodic limb movements in sleep (PLMS) occur equally in both REM and NREM sleep in RBD patients, suggesting that normal suppression of PLMS in REM sleep is due to motor inhibition.

Address correspondence to Dr. Odile Lapierre, Centre d'étude du sommeil, Hôpital du Sacré-Coeur, 5400, boul. Goinn ouest, Montréal, PQ, Canada, H4J 1C5. Address reprint requests to Dr. Jacques Montplaisir, Centre d'étude du sommeil, Hôpital du Sacré-Coeur, 5400, boul. Gouin ouest, Montréal, PQ, Canada, H4J 1C5.

Supported by the Fonds de la Recherche en Santé Mentale du Québec and by the Conseil de Recherrhe Médicale du Canada.

Received November 13, 1991. Accepted for publication in final form December 19, 1991.




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