Rinsho Shinkeigaku (Clinical Neurology)


Diagnosis, disease notification, and management of rapid eye movement (REM) sleep behavior disorder

Takayoshi Shimohata, M.D., Ph.D.1), Yuichi Inoue, M.D., Ph.D.2) and Koichi Hirata, M.D., Ph.D.3)

1)Department of Neurology, Brain Research Institute, Niigata University
2)Department of Somnology, Tokyo Medical University, Yoyogi Sleep Disorder Center
3)Department of Neurology, Dokkyo Medical University

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment behavior during REM sleep. It has been demonstrated that patients with idiopathic RBD are at a significantly increased risk of developing one of the α-synucleinopathies later in life, and this is called "phenoconversion". Although some physicians argue against disclosing information that could cause patients psychological stress, the patients also have a "right to know" about their own disease. Therefore, determining when and how to disclose this information, in addition to appropriate follow-up, is important. Clonazepam is the first choice of treatment for RBD associated with α-synucleinopathies. Since RBD is one of the premotor symptoms of α-synucleinopathies, and enables its early diagnosis, a combination of RBD and other examinations may contribute to the realization of a disease-modifying therapy. It is hoped that the early establishment of biomarkers could help predict the phenoconversion from RBD to α-synucleinopathies.
Full Text of this Article in Japanese PDF (668K)

(CLINICA NEUROL, 57: 63|70, 2017)
key words: REM sleep behavior disorder, α-synucleinopathy, non-motor symptom, premotor symptom, disease-modifying therapy

(Received: 14-Sep-16)