REM睡眠行为障碍

English | PDF,EPUB | 2018 (2019 Edition) | 667 Pages | ISBN : 3319901516 | 55.28 MB

This book describes a sleep disorder belonging to the category of parasomnias (i.e. the sleep behavioral and experiential disorders) characterized by abnormal vocal and motor behaviors in the context of vivid dreams and loss of the customary muscle atonia during the stage of sleep called REM sleep. REM-atonia - one of the defining features of REM sleep, along with rapid-eye-movements and a highly activated brain state - serves a protective function, preventing the dreamer from acting-out dreams and becoming injured. REM sleep behavior disorder (RBD) was first described in 1986 by Schenck and colleagues; since then the understanding of the condition has increased exponentially, also pointing out its strong association with the development of neurodegenerative disorders characterized by alpha synuclein deposition, such as Parkinson’s disease, Dementia with Lewy bodies, and Multiple System Atrophy. Furthermore, RBD is now considered one of the earliest markers of ongoing alpha synuclein neurodegeneration, and provides a window of opportunity for testing disease modifying therapies that may slow down or halt the progression of these disorders for which there is currently no cure.

Additionally, RBD is today known to be present in more than 50% of patients with narcolepsy-cataplexy, and can also be triggered by the most commonly prescribed antidepressant medications (e.g. SSRIs, venlafaxine). RBD has been documented as occurring, with variable frequency, with virtually every category of neurologic disease and has also helped expand the field of dream research.

The volume Editors have pioneered scientific and clinical advances in the field and, partnering with leading sleep clinicians and researchers on this book, have produced an invaluable guide to specialists in sleep medicine, neurology, psychiatry and psychology. There are also strong contributions in this book by leading basic science researchers, and so this book should also appeal to neuroscientists. As stated in the book, "RBD is situated at a strategic and busy crossroads of sleep medicine and the neurosciences. RBD offers great breadth and depth of research opportunities, including extensive inter-disciplinary and multinational research opportunities…RBD is an 'experiment of Nature' in which knowledge from the study of motor-behavioral dyscontrol during REM sleep, with dream-enactment, has cast a broad and powerful light on a multitude of Central Nervous System disturbances, their evolution, and their comorbidities."

这本书描述了一种睡眠障碍，属于parasomnias（即睡眠行为和体验性障碍）类别，表现为在梦中视觉栩栩如生且失去正常肌肉松弛的阶段快速眼动睡眠（REM睡眠）背景下出现异常的声音和运动行为。REM睡眠中的肌张力丧失——REM睡眠的一个定义特征，伴随快速眼球移动和高度激活的大脑状态——具有保护作用，防止做梦者执行梦境并受伤。 1986年，Scheneck及其同事首次描述了REM睡眠行为障碍（RBD）；从那时起，对该疾病的了解呈指数级增长，并指出其与以α-突触核蛋白沉积为特征的神经退行性疾病的发展密切相关，例如帕金森病、路易体痴呆和多系统萎缩。此外，RBD现在被认为是正在进行的α-突触核蛋白神经退行性病变的最早标志之一，也为测试可能减缓或停止这些疾病进展的潜在疗法提供了窗口。 目前，有超过50%的嗜睡症伴有惊跳（又称猝倒）患者被诊断出患有REM睡眠行为障碍，并且这种症状可以由最常用的抗抑郁药物触发（例如选择性血清素再摄取抑制剂、文拉法辛）。RBD已证明与各种神经疾病相关，频率不定，包括几乎每一个神经病理学类别。此外，它还扩展了梦境研究的领域。 该书的主编们在科学和临床方面取得了突破，并与睡眠临床专家和研究人员合作出版了一本宝贵的睡眠医学、神经科、精神科和心理学领域的指南。本书还包括来自顶尖基础科学研究者的有力贡献，因此也对神经科学家具有吸引力。正如书中所说：“RBD处于睡眠医学和神经系统领域的重要交叉点上。REM睡眠行为障碍提供了广泛的深入研究机会，包括广泛而强大的跨学科国际合作……RBD是‘自然的实验’，其中关于REM睡眠中运动行为失控与梦境再现的知识投射出对中枢神经系统异常、演变及其并发症的巨大光芒。”

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