Rapid Eye Movement Sleep Behavior Disorder: What Is Known and What Should Be Studied
Notice bibliographique
Résumé
Rapid eye movement sleep behavior disorder (RBD), characterized by vivid striking dreams and dream-enacting behaviors, can be classified as both young and old.RBD is young in that it was conceptualized as a distinct clinical disorder by Schenck et al. [1] in 1986, and it is old because it mainly affects older people.In Korea, an RBD case, confirmed by polysomnography, was reported in 1994.REM sleep without atonia (RWA) on the polysomnography is requisite for RBD diagnosis.Currently, qualitative analysis of RWA is used as RWA quantification is burdensome and time-consuming.Notably, patients complaining of vigorous dreams and violent behaviors are occasionally diagnosed with obstructive sleep apnea or show no definite RWA, which may negate diagnosis based on clinical history or RBD questionnaires.Regarding pathophysiology, dopaminergic degeneration was investigated because of its close relationship with alpha-synucleinopathies.Studies using dopamine transporter (DAT) positron emission tomography (PET) or single photon emission computed tomography (SPECT) showed that dopamine (DA) dysfunction might be implicated in RBD.However, several findings suggest that other pathogenic processes can be involved; 1) in managing RBD symptoms, effectiveness of clonazepam with no influence on DA and little effect of dopaminergic drugs, 2) appearance of RBD in narcoleptic patients, 3) young RBD patients without progression to alpha-synucleinopathies, and 4) RBD symptoms induced by antidepressants.Clonazepam is widely prescribed for the control of RBD symptoms, even if there are few randomized controlled trials on its use and it has not been demonstrated that it is superior to other benzodiazepines.Clonazepam is effective in 80% to 90% of cases with adjuvant therapy such as carbamazepine and zolpidem.Melatonin, having more tolerable side effects but less efficacy than clonazepam [2], is also used singly or in combination with clonazepam.Managing vigorous and violent behaviors is required to prevent injuries to patients themselves and their bed partners, but RBD treatment cannot modify the progression to alpha-synucleinopathies.Compared to other sleep disorders, much attention is being paid to the clinical course of RBD rather than its treatment.Studies from Spain and Canada have reported the risk of developing neurodegenerative disorders to be about 30% at 5 years and up to 80% at 10 years from the time of RBD diagnosis.Lower phenoconversion rates in Japan, China, and Korea (35.5% at 10 years and 56.5% at 14 years) might suggest racial or geographical differences in conversion [3].Biomarkers of risk factors for phenoconversion include [4-6]; older age, disease duration, motor dysfunction, mild cognitive impairment, electromyographic tonic activity, and decreased putamen DAT density.These markers can be used to classify and select patients for clinical trials of neuroprotective agents.It will take 2-3 years to complete clinical trial of therapies whose effects are demonstrated in RBD animal models [7].Probiot-
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».