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Visual hallucinations as REM sleep behavior disorders in patients with Parkinson's disease
Author(s) -
Nomura Takashi,
Inoue Yuichi,
Mitani Hidetaka,
Kawahara Ryuzo,
Miyake Masahiro,
Nakashima Kenji
Publication year - 2003
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10439
Subject(s) - psychology , rem sleep behavior disorder , audiology , multiple sleep latency test , visual hallucination , eye movement , rapid eye movement sleep , clonazepam , sleep (system call) , non rapid eye movement sleep , sleep stages , slow wave sleep , parkinson's disease , electroencephalography , polysomnography , sleep disorder , medicine , neuroscience , excessive daytime sleepiness , psychiatry , disease , cognition , operating system , computer science
To clarify whether visual hallucinations in patients with Parkinson's disease (PD) are related to rapid eye movement (REM) sleep, nocturnal polysomnographic variables were compared between a group with hallucinations (hallucinators, n = 14) and a group without hallucinations (nonhallucinators, n = 8). A multiple sleep latency test (MSLT) was performed on 3 hallucinators, and the content of dreams during daytime REM sleep was investigated. The efficacy of clonazepam, a standard treatment choice for REM sleep behavior disorders, was investigated in 8 hallucinators. Nocturnal polysomnograms of the hallucinators showed a higher amount of stage 1–REM sleep with tonic electromyogram (stage 1–REM) than the nonhallucinators, and the reported occurrences of nocturnal hallucinations corresponded with the periods of stage REM or stage 1–REM in most hallucinators. The frequency of sleep onset REM periods (SOREMP) on the MSLT were pathologically high in the hallucinators, and the content of the dreams during the MSLT period was quite similar to their hallucinations. During clonazepam treatment, the frequency of hallucinatory symptoms decreased in 5 of 8 hallucinators. These results indicate that visual hallucinations in PD are likely to be related to a REM sleep disorder manifested as the appearance of both stage 1–REM during the night and SOREMP in the daytime. © 2003 Movement Disorder Society