Sleep medicine · 2026
Sleep stage uncertainty and mixing in isolated REM sleep behavior disorder.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liu Aoqi, Ma Jiacheng, Peng Yuan, Zhang Weijie, Yang Yuanjie, Zhang Puxiao, Hua Xinyue, Yang Chen, Wu Guoli, He Lihua, Ai Sizhi, Feng Hongliang, Huang Bei, Wing Yun Kwok, Zhang Jihui, Wang Jing, Liu Yaping
Аннотация
BACKGROUND: Isolated REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies, including Parkinson's disease (PD). Conventional sleep staging assigns each epoch to a single dominant stage, potentially obscuring within-epoch probabilistic features and stage mixing. We aimed to characterize alternation of probabilistic sleep-stage patterns in iRBD and to examine their clinical and neurobiological correlations.
METHODS: In this case-control study, 104 patients with iRBD, 28 patients with PD and RBD (PD + RBD), and 50 controls underwent video polysomnography. Sleep-stage uncertainty and mixing were quantified using the U-Sleep 2.0 model. Clinical measures included RBD symptom severity (RBDQ-HK), motor function (UPDRS-III), and cognition (MoCA). Nigrostriatal dopaminergic function was assessed with [18F]-DOPA PET in a subgroup consisting of 40 patients with iRBD. Within the iRBD group, associations between probabilistic sleep-stage metrics and mixing with clinical measures and PET metrics were assessed using Pearson correlations.
RESULTS: Both iRBD and PD + RBD groups exhibited significantly increased sleep-stage uncertainty and mixing compared with controls. Within the iRBD group, REM uncertainty was positively correlated with RBD symptom severity (RBDQ-HK score, r = 0.364, p = 0.003) and motor symptoms (UPDRS-III score, r = 0.343, p = 0.005). N2 uncertainty was negatively correlated with global cognitive performance (MoCA score, r = -0.345, p = 0.005), particularly delayed recall (r = -0.402, p < 0.001). N2-REM mixing was positively correlated with RBD symptom severity (RBDQ-HK score, r = 0.449, p < 0.001) and negatively correlated with bilateral putaminal dopaminergic uptake on PET (left: r = -0.492, p = 0.019; right: r = -0.510, p = 0.019).
CONCLUSIONS: Probabilistic sleep staging reveals clinically significant alterations in sleep-stage uncertainty and stage mixing in iRBD and may provide complementary electrophysiological markers of early α-synuclein-related neurodegeneration.
METHODS: In this case-control study, 104 patients with iRBD, 28 patients with PD and RBD (PD + RBD), and 50 controls underwent video polysomnography. Sleep-stage uncertainty and mixing were quantified using the U-Sleep 2.0 model. Clinical measures included RBD symptom severity (RBDQ-HK), motor function (UPDRS-III), and cognition (MoCA). Nigrostriatal dopaminergic function was assessed with [18F]-DOPA PET in a subgroup consisting of 40 patients with iRBD. Within the iRBD group, associations between probabilistic sleep-stage metrics and mixing with clinical measures and PET metrics were assessed using Pearson correlations.
RESULTS: Both iRBD and PD + RBD groups exhibited significantly increased sleep-stage uncertainty and mixing compared with controls. Within the iRBD group, REM uncertainty was positively correlated with RBD symptom severity (RBDQ-HK score, r = 0.364, p = 0.003) and motor symptoms (UPDRS-III score, r = 0.343, p = 0.005). N2 uncertainty was negatively correlated with global cognitive performance (MoCA score, r = -0.345, p = 0.005), particularly delayed recall (r = -0.402, p < 0.001). N2-REM mixing was positively correlated with RBD symptom severity (RBDQ-HK score, r = 0.449, p < 0.001) and negatively correlated with bilateral putaminal dopaminergic uptake on PET (left: r = -0.492, p = 0.019; right: r = -0.510, p = 0.019).
CONCLUSIONS: Probabilistic sleep staging reveals clinically significant alterations in sleep-stage uncertainty and stage mixing in iRBD and may provide complementary electrophysiological markers of early α-synuclein-related neurodegeneration.