在孤立的REM睡眠行为障碍中静止性低血压的频率
Jonathan E Elliott1, Mohini D Bryant-Ekstrand1, Allison T Keil1
1Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada.
正静性低血压 (OH) 和卧底高血压 (sHTN) 在孤立的REM睡眠行为障碍 (iRBD) 中很常见. 由于这些患者潜在的自主性症状意识降低,建议进行静止式立体测试.
科学领域:
- 神经学 神经学
- 睡眠医学 睡眠医学
- 自主神经科学 自主神经科学
背景情况:
- 静止性低血压 (OH) 可能是孤立REM睡眠行为障碍 (iRBD) 中自主功能障碍的早期指标.
- 之前关于iRBD中OH频率的大型研究缺乏.
- 这项研究前性地评估了大量IRBD队列中的OH患病率.
研究的目的:
- 为了确定静止性低血压 (OH) 的频率,在一个大型的,多中心队列患者与孤立的REM睡眠行为障碍 (iRBD).
- 调查iRBD患者的OH特征,包括心率降低增加和卧底高血压.
主要方法:
- 预计将18岁以上的参与者注册为视频多梦图确认的iRBD.
- 标准化的3分钟静态立体测试来评估OH频率.
- 使用 Δ 心率/Δ 缩血压 (ΔHR/ΔSBP) 比率 <0.5.5 的心率降低增高的评估.
- 综合评估包括SCOPA-AUT,认知,运动,精神和感官评估.
主要成果:
- 在340名iRBD参与者中,27% (93人) 符合OH标准.
- 在患有OH的人中,77% (72人) 呈现心率降低或心率增加.
- 在iRBD患者中,在72%的OH患者中观察到辅食性高血压 (sHTN).
- OH与年龄较大,RBD症状较早出现和嗅觉较差有关,但与SCOPA-AUT得分无关.
结论:
- 正静性低血压 (OH) 和卧底高血压 (sHTN) 在孤立的REM睡眠行为障碍 (iRBD) 中很普遍.
- 建议在iRBD患者中对OH进行临床评估,考虑到自主症状意识的潜在缺陷.
- 需要进一步的纵向研究,以了解OH与iRBD中的转换风险之间的联系.
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