Literature DB >> 30833231

Clinical progression in Parkinson's disease with features of REM sleep behavior disorder: A population-based longitudinal study.

Aline Duarte Folle1, Kimberly C Paul1, Jeff M Bronstein2, Adrienne M Keener3, Beate Ritz4.   

Abstract

INTRODUCTION: Rapid Eye Movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment and is associated with incidence of neurodegenerative disorders, especially Parkinson's disease (PD). Whether PD with RBD constitutes a distinct subtype with unique progression is unknown. Here, we investigated motor and cognitive symptom progression in patients with self-reported RBD features in adult life.
METHODS: We screened for RBD in a cohort of 776 PD patients whom we ascertained using a population-based strategy. Among participants with at least one follow-up (60%), we compared those with and without probable RBD (pRBD) estimating hazard rate ratios for progression events UPDRS-III≥ 35 and MMSE≤ 24.
RESULTS: Prevalence of pRBD at baseline was 21%. In adjusted Cox regression models among patients with a Postural Instability and Gait Dysfunction (PIGD) phenotype, those with pRBD progressed faster to a UPDRS-III≥ 35 (HR = 1.92, 95% CI = 1.12; 3.27). Also, all patients with pRBD progressed twice as fast to a MMSE score≤ 24 (HR = 2.04, 95% CI = 1.13; 3.69). In sensitivity analyses, using alternative definition of pRBD and accounting for bias due to loss to follow-up results remained similar. DISCUSSION: Employing data from one of the largest population-based studies of PD, in which movement disorder specialists assessed patients, we confirm evidence that pRBD features are a clinical marker for faster cognitive decline and possibly also motor progression in PD patients, the latter for patients with a PIGD subtype early in disease.
Copyright © 2019 Elsevier Ltd. All rights reserved.

Entities:  

Keywords:  Cognitive decline; Motor progression; Parkinson's disease; REM sleep behavior disorder; Sleep

Mesh:

Year:  2019        PMID: 30833231      PMCID: PMC6589360          DOI: 10.1016/j.parkreldis.2019.01.018

Source DB:  PubMed          Journal:  Parkinsonism Relat Disord        ISSN: 1353-8020            Impact factor:   4.891


  30 in total

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2.  Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and Parkinson's disease.

Authors:  R B Postuma; J F Gagnon; M Vendette; J Y Montplaisir
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Review 5.  Classification of sleep disorders.

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10.  Brainstem Quadruple Aberrant Hyperphosphorylated Tau, Beta-Amyloid, Alpha-Synuclein and TDP-43 Pathology, Stress and Sleep Behavior Disorders.

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