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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
PubMed
Abstract

Insights

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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