비디오 안진 검사를 이용한 렘수면행동장애의 뇌줄기 기능 저하에 대한 연구
A Study on the Evaluation of Brainstem Dysfunction in Rapid Eye Movement Sleep Behavior Disorder Using Video Nystagmography
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Background: This study aimed to differentiate video nystagmography (VNG) characteristics, including the video head impulse test (vHIT), in patients with idiopathic rapid eye movement behavior disorder (RBD) from healthy controls, which is considered a precursor to degenerative diseases. Methods: One hundred eighty-five patients underwent overnight polysomnography (PSG) and VNG. Based on overnight PSG, 27 patients with RBD or REM sleep without atonia (RWA) and AHI<15 were categorized into the RBD group, 34 patients with RBD/RWA and AHI≥15 were grouped into the combined group. Sixty patients with AHI≥15 and no RBD/RWA were included in the obstructive sleep apnea (OSA) group, and 64 negative participants were assigned to the control group. In VNG, we measured the gain of vHIT in each canal, with the latency, amplitude, and velocity of horizontal saccades and smooth pursuit. We compared the results between groups using ANOVA, after normalization and adjustment for age and sex. Results: The gain of vHIT in the left horizontal canal was decreased in the RBD group, but it was more pronounced in the OSA group. Elevated gain of the left posterior canal was seen in the RBD group, but technical errors were attributable. The RBD group displayed prolonged latency of saccade on the left side and slowed saccade on the right side, but these were statistically insignificant. Conclusions: The VNG study revealed differences between the sleep disorders, potentially reflecting brainstem function in each disorder. However, these differences lacked statistical significance. We anticipate that significant results could be obtained with more controlled conditions.
Abstract
Background: This study aimed to differentiate video nystagmography (VNG) characteristics, including the video head impulse test (vHIT), in patients with idiopathic rapid eye movement behavior disorder (RBD) from healthy controls, which is considered a precursor to degenerative diseases. Methods: One hundred eighty-five patients underwent overnight polysomnography (PSG) and VNG. Based on overnight PSG, 27 patients with RBD or REM sleep without atonia (RWA) and AHI<15 were categorized into the RBD group, 34 patients with RBD/RWA and AHI≥15 were grouped into the combined group. Sixty patients with AHI≥15 and no RBD/RWA were included in the obstructive sleep apnea (OSA) group, and 64 negative participants were assigned to the control group. In VNG, we measured the gain of vHIT in each canal, with the latency, amplitude, and velocity of horizontal saccades and smooth pursuit. We compared the results between groups using ANOVA, after normalization and adjustment for age and sex. Results: The gain of vHIT in the left horizontal canal was decreased in the RBD group, but it was more pronounced in the OSA group. Elevated gain of the left posterior canal was seen in the RBD group, but technical errors were attributable. The RBD group displayed prolonged latency of saccade on the left side and slowed saccade on the right side, but these were statistically insignificant. Conclusions: The VNG study revealed differences between the sleep disorders, potentially reflecting brainstem function in each disorder. However, these differences lacked statistical significance. We anticipate that significant results could be obtained with more controlled conditions.
참고문헌 (14)
- St Louis EK, "REM sleep behavior disorder : diagnosis, clinical implications, and future directions", Mayo Clin Proc, 92, pp.1723~1736 (2017)
- Fife TD, "Practice guideline : cervical and ocular vestibular evoked myogenic potential testing : report of the guideline development, dissemination, and implementation Subcommittee of the American Academy of Neurology", Neurology, 89, pp.2288~2296 (2017)
- Postuma RB, "REM sleep behavior disorder and prodromal neurodegeneration-where are we headed?", Tremor Other Hyperkinet Mov (NY), 3, pp.tre-03-134-2929-1~ (2013)
- de Natale ER, "Vestibular evoked myogenic potentials are abnormal in idiopathic REM sleep behavior disorder", Front Neurol, 9, pp.911~ (2018)
- Chung WH, "Basic principles of vestibulo-ocular reflex(VOR)", J Korean Bal Soc, 5, pp.111~125 (2006)
- 배효은, "Evaluation of Vestibular Function in Sleep Disorders", Journal of sleep medicine, 19(3), pp.117~124 (2022), 대한수면연구학회[DOI]
- Micarelli A, "Integrating postural and vestibular dimensions to depict impairment in moderate-to-severe obstructive sleep apnea syndrome patients", J Sleep Res, 26, pp.487~494 (2017)
- Macey PM, "Brain structural changes in obstructive sleep apnea", Sleep, 31, pp.967~977 (2008)
- Louise Hag, "Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals", Research in Vestibular Science, 19(2), pp.62~70 (2020), 대한평형의학회[DOI]
- Mossman B, "Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography", J Otolaryngol Head Neck Surg, 44, pp.29~ (2015)
- Gallina S, "Obstructive sleep apnea syndrome(OSAS) : effects on the vestibular system", Acta Otorhnolaryngol Ital, 30, pp.281~284 (2010)
- 이정엽, "비디오두부충동검사의 임상적 적용 및 최신 지견", Research in Vestibular Science, 17(3), pp.79~89 (2018), 대한평형의학회[DOI]
- Lee SH, "Saccadic system", Clin Neuroophthalmol, 1, pp.10~14 (2011)
- Lal V, "Eye movement abnormalities in movement disorders", Clin Park Relat Disord, 1, pp.54~63 (2019)