Abstract | OBJECTIVE: Rapid eye movement ( REM) sleep behavior disorder (RBD) may be a risk factor for dementia development in patients with Parkinson's disease (PD); however, the role of subclinical RBD remains unknown. Patients with PD and clinical RBD, subclinical RBD, or with normal REM sleep were examined in a cross sectional study and a longitudinal follow-up. METHODS: Interviews regarding RBD symptoms and polysomnographies were performed on 82 PD patients divided into RBD subcategories based on the presence/absence of REM sleep without atonia (RWA) and/or RBD symptoms. Descriptive variables were compared and patients were followed-up longitudinally for 21.4±10.8months. RESULTS: The existence of RBD, but not subclinical RBD, was associated with orthostatic hypotension and levodopa dose equivalents (LDEs) in patients with PD. Kaplan-Myer curves indicated that the occurrence of dementia in the PD group with clinical RBD was significantly faster than in the PD group with normal REM sleep (p=0.013). A Cox hazard regression analysis revealed that development to PD with dementia was only significantly associated with the presence of clinical RBD (hazard ratio: 14.1, p=0.017). CONCLUSION: Clinical RBD symptoms, but not subclinical RBD, were associated with the development of dementia in PD.
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Authors | Takashi Nomura, Yuichi Inoue, Tatsuo Kagimura, Kenji Nakashima |
Journal | Sleep medicine
(Sleep Med)
Vol. 14
Issue 2
Pg. 131-5
(Feb 2013)
ISSN: 1878-5506 [Electronic] Netherlands |
PMID | 23218532
(Publication Type: Journal Article)
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Copyright | Copyright © 2012 Elsevier B.V. All rights reserved. |
Chemical References |
- Antiparkinson Agents
- Levodopa
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Topics |
- Aged
- Aged, 80 and over
- Antiparkinson Agents
(adverse effects, therapeutic use)
- Autonomic Nervous System
(physiopathology)
- Blood Pressure
(physiology)
- Cross-Sectional Studies
- Dementia
(diagnosis, epidemiology, physiopathology)
- Disability Evaluation
- Dose-Response Relationship, Drug
- Female
- Heart
(innervation)
- Humans
- Hypotension, Orthostatic
(diagnosis, epidemiology, physiopathology)
- Kaplan-Meier Estimate
- Levodopa
(adverse effects, therapeutic use)
- Longitudinal Studies
- Male
- Middle Aged
- Parkinson Disease
(diagnosis, drug therapy, epidemiology, physiopathology)
- Polysomnography
- Prognosis
- Proportional Hazards Models
- REM Sleep Behavior Disorder
(diagnosis, epidemiology, physiopathology)
- Sleep Stages
(physiology)
- Tilt-Table Test
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