Ariel B Neikrug1, Julie A Avanzino2, Lianqi Liu3, Jeanne E Maglione2, Loki Natarajan4, Jody Corey-Bloom5, Barton W Palmer6, Jose S Loredo7, Sonia Ancoli-Israel8. 1. SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. 2. Department of Psychiatry, University of California, San Diego, CA, USA. 3. Department of Psychiatry, University of California, San Diego, CA, USA; Department of Veterans Affairs, San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA. 4. Department of Family and Preventative Medicine, University of California, San Diego, CA, USA. 5. Department of Neurosciences, University of California, San Diego, CA, USA. 6. SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Medical Research Foundation, San Diego, CA, USA. 7. Department of Medicine, University of California, San Diego, CA, USA. 8. SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Department of Veterans Affairs, San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA; Veterans Medical Research Foundation, San Diego, CA, USA; Department of Medicine, University of California, San Diego, CA, USA. Electronic address: sancoliisrael@ucsd.edu.
Abstract
OBJECTIVE: Rapid eye movement (REM)-sleep behavior disorder (RBD) is often comorbid with Parkinson's disease (PD). The current study aimed to provide a detailed understanding of the impact of having RBD on multiple non-motor symptoms (NMS) in patients with PD. METHODS: A total of 86 participants were evaluated for RBD and assessed for multiple NMS of PD. Principal component analysis was utilized to model multiple measures of NMS in PD, and a multivariate analysis of variance was used to assess the relationship between RBD and the multiple NMS measures. Seven NMS measures were assessed: cognition, quality of life, fatigue, sleepiness, overall sleep, mood, and overall NMS of PD. RESULTS: Among the PD patients, 36 were classified as having RBD (objective polysomnography and subjective findings), 26 as not having RBD (neither objective nor subjective findings), and 24 as probably having RBD (either subjective or objective findings). RBD was a significant predictor of increased NMS in PD while controlling for dopaminergic therapy and age (p=0.01). The RBD group reported more NMS of depression (p=0.012), fatigue (p=0.036), overall sleep (p=0.018), and overall NMS (p=0.002). CONCLUSION: In PD, RBD is associated with more NMS, particularly increased depressive symptoms, sleep disturbances, and fatigue. More research is needed to assess whether PD patients with RBD represent a subtype of PD with different disease progression and phenomenological presentation.
OBJECTIVE:Rapid eye movement (REM)-sleep behavior disorder (RBD) is often comorbid with Parkinson's disease (PD). The current study aimed to provide a detailed understanding of the impact of having RBD on multiple non-motor symptoms (NMS) in patients with PD. METHODS: A total of 86 participants were evaluated for RBD and assessed for multiple NMS of PD. Principal component analysis was utilized to model multiple measures of NMS in PD, and a multivariate analysis of variance was used to assess the relationship between RBD and the multiple NMS measures. Seven NMS measures were assessed: cognition, quality of life, fatigue, sleepiness, overall sleep, mood, and overall NMS of PD. RESULTS: Among the PDpatients, 36 were classified as having RBD (objective polysomnography and subjective findings), 26 as not having RBD (neither objective nor subjective findings), and 24 as probably having RBD (either subjective or objective findings). RBD was a significant predictor of increased NMS in PD while controlling for dopaminergic therapy and age (p=0.01). The RBD group reported more NMS of depression (p=0.012), fatigue (p=0.036), overall sleep (p=0.018), and overall NMS (p=0.002). CONCLUSION: In PD, RBD is associated with more NMS, particularly increased depressive symptoms, sleep disturbances, and fatigue. More research is needed to assess whether PDpatients with RBD represent a subtype of PD with different disease progression and phenomenological presentation.
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