HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 61, Number 1, July 08, 2003 Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gilman, S. Articles by Heumann, M. Search for Related Content PubMed PubMed Citation Articles by Gilman, S. Articles by Heumann, M. Related Collections Multiple system atrophy All Sleep Disorders

REM sleep behavior disorder is related to striatal monoaminergic deficit in MSA

From the Department of Neurology (Drs. Gilman, Chervin, Consens, and Junck, M. Heumann); Division of Nuclear Medicine (Dr. Koeppe), Department of Radiology; and Department of Biostatistics (Dr. Little, H. An); University of Michigan, Ann Arbor.

Address correspondence and reprint requests to Dr. S. Gilman, Department of Neurology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0316; e-mail: sgilman{at}umich.edu

Objective: To explore the neurochemical basis of REM sleep behavior disorder (RBD) in multiple-system atrophy (MSA).

Methods: In 13 patients with probable MSA, nocturnal, laboratory-based polysomnography was used to rate the severity of REM atonia loss by the percentage of REM sleep with tonically increased electromyographic (EMG) activity and the percentage of REM sleep with phasic EMG bursts. PET with (+)-[¹¹C]dihydrotetrabenazine ([¹¹C]DTBZ) was employed to measure the density of striatal monoaminergic terminals and SPECT with (-)-5-[¹²³I]iodobenzovesamicol ([¹²³I]IBVM) to measure the density of thalamic cholinergic terminals. Data in the patient group were compared with data from 15 normal control subjects scanned with [¹¹C]DTBZ and 12 with [¹²³I]IBVM.

Results: Age and gender distributions were similar in patient and normal control groups. The MSA subjects showed decreased mean [¹¹C]DTBZ binding in the striatum (p < 0.0001) and decreased [¹²³I]IBVM binding in the thalamus (p < 0.001). Moreover, in the MSA group, striatal [¹¹C]DTBZ binding was inversely correlated with the severity of REM atonia loss (p = 0.003). Thalamic [¹²³I]IBVM binding, however, was not correlated to the severity of REM atonia loss.

Conclusion: Decreased nigrostriatal dopaminergic projections may contribute to RBD in MSA.

This article has been cited by other articles:

				A. Y. Avidan Sleep and Neurodegenerative Disorders ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 27 - 44. [Full Text] [PDF]

				A. Y. Avidan Parasomnias ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 77 - 92. [Full Text] [PDF]

				I. Tuin, U. Voss, J. -S. Kang, K. Kessler, U. Rub, D. Nolte, H. Lochmuller, S. Tinschert, D. Claus, K. Krakow, et al. Stages of sleep pathology in spinocerebellar ataxia type 2 (SCA2) Neurology, December 12, 2006; 67(11): 1966 - 1972. [Abstract] [Full Text] [PDF]

				C. H. Adler and M. J. Thorpy Sleep issues in Parkinson's disease Neurology, June 28, 2005; 64(12_suppl_3): S12 - S20. [Abstract] [Full Text] [PDF]

				F. Salih, R. Khatami, S. Steinheimer, O. Hummel, A. Kuhn, and P. Grosse Inhibitory and excitatory intracortical circuits across the human sleep-wake cycle using paired-pulse transcranial magnetic stimulation J. Physiol., June 1, 2005; 565(2): 695 - 701. [Abstract] [Full Text] [PDF]

				M. G. Schlossmacher, C. Hamann, A. G. Cole, R. G. Gonzalez, and M. P. Frosch Case 27-2004 - A 79-Year-Old Woman with Disturbances in Gait, Cognition, and Autonomic Function N. Engl. J. Med., August 26, 2004; 351(9): 912 - 922. [Full Text] [PDF]

				J. K. Matheson and C. B. Saper REM sleep behavior disorder: A dopaminergic deficiency disorder? Neurology, November 25, 2003; 61(10): 1328 - 1329. [Full Text] [PDF]

				S. Gilman, R. D. Chervin, R. A. Koeppe, F.B. Consens, R. Little, H. An, L. Junck, and M. Heumann Obstructive sleep apnea is related to a thalamic cholinergic deficit in MSA Neurology, July 8, 2003; 61(1): 35 - 39. [Abstract] [Full Text] [PDF]