Increased sighing during sleep as a marker of multiple system atrophy

IF 6.7 1区 医学 Q1 NEUROSCIENCES NPJ Parkinson's Disease Pub Date : 2024-09-16 DOI:10.1038/s41531-024-00765-4
Estefania Vargas Gonzalez, Zhongmei Yang, Pauline Dodet, Smaranda Leu-Semenescu, Cécile Londner, Maxime Patout, Christian Straus, Thomas Similowski, David Grabli, Marie Vidailhet, Isabelle Arnulf
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Abstract

Parkinson’s disease (PD) and multiple system atrophy (MSA) can be preceded by isolated REM sleep behavior disorder (iRBD). As excessive sighing during wakefulness is a red flag for MSA in individuals with parkinsonism, we measured sighing during slow wave sleep (N3) and REM sleep as potential biomarkers in 73 participants with MSA, 111 with iRBD, 257 with PD, and 115 controls. The number of sighs/hour of N3 (index) was higher in the MSA group than in the other groups. Sighs were rarer in REM sleep than in N3 sleep. A sigh index greater than 3.4/h of N3 was 95% sensitive in discriminating participants with MSA from controls, and a sigh index greater than 0.8 sigh/h of REM sleep was 87% specific in discriminating participants with MSA from controls. MSA participants with (vs. without) sigh were younger, had a lower apnea-hypopnea index (but no more stridor), and had no other difference in motor, autonomic, cognitive, and sensory symptoms. The sigh index could be used for screening for MSA in the millions of middle-aged persons who receive polysomnography for other purposes. Whether sighing in iRBD predicts preferential conversion towards MSA should be measured in a longitudinal study.

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睡眠中叹息声增多是多系统萎缩的标志
帕金森病(Parkinson's disease,PD)和多系统萎缩(Multiple system atrophy,MSA)发病前可能会出现孤立的快速眼动睡眠行为障碍(REM sleep behavior disorder,iRBD)。由于清醒时过度叹息是帕金森病患者出现 MSA 的一个信号,因此我们测量了 73 名 MSA 患者、111 名 iRBD 患者、257 名帕金森病患者和 115 名对照组患者在慢波睡眠(N3)和快速眼动睡眠时的叹息,作为潜在的生物标记物。MSA组每小时N3的叹息次数(指数)高于其他组别。快速动眼期睡眠中的叹息次数少于 N3 睡眠。在区分 MSA 患者和对照组时,N3 睡眠中叹息指数大于 3.4 次/小时的敏感度为 95%,而在区分 MSA 患者和对照组时,REM 睡眠中叹息指数大于 0.8 次/小时的特异度为 87%。有(与没有)叹息的 MSA 患者更年轻,呼吸暂停-低通气指数更低(但没有更多的哮鸣音),在运动、自主神经、认知和感觉症状方面没有其他差异。叹气指数可用于筛查因其他原因接受多导睡眠图检查的数百万中年人的 MSA。至于 iRBD 患者的叹息是否预示着会优先转为 MSA,则应在纵向研究中进行测量。
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来源期刊
NPJ Parkinson's Disease
NPJ Parkinson's Disease Medicine-Neurology (clinical)
CiteScore
9.80
自引率
5.70%
发文量
156
审稿时长
11 weeks
期刊介绍: npj Parkinson's Disease is a comprehensive open access journal that covers a wide range of research areas related to Parkinson's disease. It publishes original studies in basic science, translational research, and clinical investigations. The journal is dedicated to advancing our understanding of Parkinson's disease by exploring various aspects such as anatomy, etiology, genetics, cellular and molecular physiology, neurophysiology, epidemiology, and therapeutic development. By providing free and immediate access to the scientific and Parkinson's disease community, npj Parkinson's Disease promotes collaboration and knowledge sharing among researchers and healthcare professionals.
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