Cited by 231Parkinson's Disease Mechanisms and TreatmentsSleep and related disordersSleep and Wakefulness Research

REM sleep behavior disorder: motor manifestations and pathophysiology

Arnulf, Isabelle·2012·Movement Disorders

Abstract

Patients with REM sleep behavior disorder (RBD) enact violent dreams during REM sleep in the absence of normal muscle atonia. This disorder is highly frequent in patients with synucleinopathies (60%-100% of patients) and rare in patients with other neurodegenerative disorders. The disorder is detected by interview plus video and sleep monitoring. Abnormal movements expose the patients and bed partners to a high risk of injury and sleep disruption. The disorder is usually alleviated with melatonin and clonazepam. Limb movements are mainly minor, jerky, fast, pseudohallucinatory, and repeated, with a limp wrist during apparently grasping movements, although body jerks and complex violent (fights) and nonviolent culturally acquired behaviors are also observed. Notably, parkinsonism disappears during RBD-associated complex behaviors in patients with Parkinson's disease and with multiple system atrophy, suggesting that the upper motor stream bypasses the basal ganglia during REM sleep. Longitudinal studies show that idiopathic RBD predisposes patients to later develop Parkinson's disease, dementia with Lewy bodies, and, more rarely, multiple system atrophy, with a rate of conversion of 46% within 5 years. During this time window, patients concomitantly develop nonmotor signs (decreased olfaction and color vision, orthostatic hypotension, altered visuospatial abilities, increased harm avoidance) and have abnormal test results (decreased putamen dopamine uptake, slower EEG). Patients with idiopathic RBD have higher and faster risk for conversion to Parkinson's disease and dementia with Lewy bodies if abnormalities in dopamine transporter imaging, transcranial sonography, olfaction, and color vision are found at baseline. They constitute a highly specific target for testing neuroprotective agents.

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Crossref · 10.1002/mds.24957

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  • The DEB can be a viable access to dreams, overcoming the intrinsic difficulty to study dreaming.

    “Finally, considering that dreaming is an irregular phenomenon and not always observable, it should be considered that a new frontier to investigate more directly the relationship between dreaming and emotions is represented by the DEB (Rivera-García et al., 2018) that can be a viable access to dreams, overcoming the intrinsic difficulty to study this phenomenon (Arnulf, 2012; Alfonsi et al., 2019)”

    From The Functional Role of Dreaming in Emotional Processes (2019) · cites this paper as Arnulf, 2012

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Authors
Arnulf, I.
Affiliations
Inserm (FR)
Corresponding author
Arnulf, Isabelle
Venue
Movement Disorders
Publisher
Wiley
Published
2012-03-22
Volume
27
Issue
6
Pages
677-689
ISSN
  • 0885-3185 (ISSN-L)
  • 1531-8257
OpenAlex
W2057270473
Cited by
231
References
105
Citations by year
2026: 14 · 2025: 11 · 2024: 11 · 2023: 13 · 2022: 13 · 2021: 19 · 2020: 12 · 2019: 18 · 2018: 16 · 2017: 20 · 2016: 23 · 2015: 19 · 2014: 17 · 2013: 18 · 2012: 5
FWCI
2.63
Type
journal article
Language
en
Open access
closed
Locations
  • Movement Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
REM sleep behavior disorder, synucleinopathies, Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, REM sleep atonia, dopamine transporter imaging, olfactory dysfunction, color vision deficiency, orthostatic hypotension, melatonin, clonazepam, basal ganglia, neurodegeneration risk
MeSH terms
Cognition Disorders, Dementia, Humans, Parkinson Disease, Sleep, REM, REM Sleep Behavior Disorder

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