Mario Meloni1, Marco Bortolato2, Antonino Cannas3, Ilaria Laccu4, Michela Figorilli4, Patrizia Congiu4, Giovanni Defazio3, Federico Meloni5, Monica Puligheddu6,7. 1. IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy. 2. Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA. 3. Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy. 4. Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Asse didattico E SS 554, Bivio Sestu, 09042, Monserrato, Cagliari, Italy. 5. Occupational Health Section, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy. 6. Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari and AOU Cagliari, Monserrato, Cagliari, Italy. puligheddu@unica.it. 7. Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Asse didattico E SS 554, Bivio Sestu, 09042, Monserrato, Cagliari, Italy. puligheddu@unica.it.
Abstract
BACKGROUND: Rapid eye movement sleep behavior disorder (RBD) is highly comorbid with Parkinson's disease (PD). Emerging evidence suggests that dopamine-replacement therapies (DRTs) for PD may modify the course of RBD, yet the nature of the association between DRTs and RBD remains unclear. To begin addressing this issue, we conducted a preliminary retrospective study to document whether DRTs are associated with the occurrence of RBD symptoms in PD patients. METHODS: The study included 250 PD patients who were screened for probable RBD via the RBD Screening Questionnaire (RBDSQ). For each patient, disease severity data were collected, in addition to their therapy and the associated levodopa equivalent daily dose (LEDD). The association between DRTs and RBDSQ scores was analyzed using logistic regression and correlation models. RESULTS: RBD scores were found to be associated with the LEDD of levodopa alone, but not of dopaminergic agonists (mainly D2/D3 receptor agonists) or their combination with levodopa. This association was not accounted for patient age or Hoehn and Yahr (H&Y) severity scores. CONCLUSIONS: Our study detected a significant association between doses of levodopa and RBD symptoms in PD patients. Future longitudinal studies are needed to establish what causal nexus may link these variables.
BACKGROUND: Rapid eye movement sleep behavior disorder (RBD) is highly comorbid with Parkinson's disease (PD). Emerging evidence suggests that dopamine-replacement therapies (DRTs) for PD may modify the course of RBD, yet the nature of the association between DRTs and RBD remains unclear. To begin addressing this issue, we conducted a preliminary retrospective study to document whether DRTs are associated with the occurrence of RBD symptoms in PDpatients. METHODS: The study included 250 PDpatients who were screened for probable RBD via the RBD Screening Questionnaire (RBDSQ). For each patient, disease severity data were collected, in addition to their therapy and the associated levodopa equivalent daily dose (LEDD). The association between DRTs and RBDSQ scores was analyzed using logistic regression and correlation models. RESULTS: RBD scores were found to be associated with the LEDD of levodopa alone, but not of dopaminergic agonists (mainly D2/D3 receptor agonists) or their combination with levodopa. This association was not accounted for patient age or Hoehn and Yahr (H&Y) severity scores. CONCLUSIONS: Our study detected a significant association between doses of levodopa and RBD symptoms in PDpatients. Future longitudinal studies are needed to establish what causal nexus may link these variables.