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Brainstem infarcts predict REM sleep behavior disorder in acute ischemic stroke.
Wai Kwong Tang1, Dirk M Hermann, Yang Kun Chen
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China. tangwk@cuhk.edu.hk.
BMC Neurology
|April 25, 2014
Summary
Brainstem infarcts are a key factor in developing REM sleep behavior disorder (RBD) after stroke. Patients with brainstem strokes should be evaluated for RBD by a neurologist.
Area of Science:
- Neurology
- Sleep Medicine
- Stroke Research
Background:
- Rapid eye movement (REM) sleep behavior disorder (RBD) involves acting out dreams during REM sleep, posing risks of injury.
- RBD is common in neurodegenerative diseases like Parkinson's but its link to stroke is less understood.
- This study investigated factors contributing to RBD in acute ischemic stroke patients.
Purpose of the Study:
- To identify factors influencing the development of RBD in patients experiencing acute ischemic stroke.
- To determine the prevalence and characteristics of RBD in a stroke cohort.
Main Methods:
- Prospective study of 2,024 acute ischemic stroke patients; 119 met criteria for analysis.
- Data collected included demographics, stroke severity (NIHSS), and cognitive function (MMSE).
- Patients completed the 13-item RBD questionnaire (RBDQ) 3 months post-stroke.
Main Results:
- 10.9% of stroke patients exhibited RBD (RBDQ score ≥ 19).
- Brainstem infarcts were significantly more common in patients with RBD.
- Brainstem infarcts independently predicted RBD development (OR=3.686, P=0.032), even with smaller infarct volumes.
Conclusions:
- Brainstem injury plays a significant role in the development of RBD following ischemic stroke.
- Clinical neurologists should evaluate stroke patients with brainstem infarcts for potential RBD.
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