Clinical significance of REM sleep behavior disorder in Parkinson's disease.

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.

• 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)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Chemical References

• Antiparkinson Agents
• Levodopa

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