Cognitive impairment in REM-sleep behaviour disorder and individuals at risk of Parkinson's disease

Nagy, Anett; Leschziner, Guy; Eriksson, S.H.; Lees, Andrew J.; Noyce, Alastair J.; Schrag, Anette

doi:10.1016/j.parkreldis.2023.105312

Cited by 8 publications

(5 citation statements)

References 19 publications

(19 reference statements)

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“…Past studies have presented alternative perspectives on whether RBD and early-stage PD share similar cognitive impairments 24 , 34 – 37 , with the concept of a distinct cognitive profile for individuals transitioning from RBD to PD being debated 35 . While intuitively, RBD as a prodrome might be expected to exhibit less severe cognitive deficits than those observed after PD phenoconversion, studies have indicated that individuals who transition from RBD to PD tend to experience more significant cognitive deficits 35 .…”

Section: Discussionmentioning

confidence: 99%

“…For example, PD-associated cognitive deficits have been reported to include memory, attention, visuospatial abilities, and particularly executive functions, such as mental flexibility, set-shifting, switching, efficient planning of future actions, and problem-solving 1 . Meanwhile, RBD deficits have also been reported in attention and memory domains 24 . An optimal assessment battery should encompass and differentiate between these cognitive domains, i.e., with tasks that have sensitivity to PD or RBD and that are decorrelated from each other to provide detailed multivariate deficit profiles.…”

Section: Introductionmentioning

confidence: 99%

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Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder

Bălăeţ,

Alhajraf,

Zerenner

et al. 2024

npj Digit. Med.

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Automated online cognitive assessments are set to revolutionise clinical research and healthcare. However, their applicability for Parkinson’s Disease (PD) and REM Sleep Behavioural Disorder (RBD), a strong PD precursor, is underexplored. Here, we developed an online battery to measure early cognitive changes in PD and RBD. Evaluating 19 candidate tasks showed significant global accuracy deficits in PD (0.65 SD, p = 0.003) and RBD (0.45 SD, p = 0.027), driven by memory, language, attention and executive underperformance, and global reaction time deficits in PD (0.61 SD, p = 0.001). We identified a brief 20-min battery that had sensitivity to deficits across these cognitive domains while being robust to the device used. This battery was more sensitive to early-stage and prodromal deficits than the supervised neuropsychological scales. It also diverged from those scales, capturing additional cognitive factors sensitive to PD and RBD. This technology offers an economical and scalable method for assessing these populations that can complement standard supervised practices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder

Bălăeţ,

Alhajraf,

Zerenner

et al. 2024

npj Digit. Med.

View full text Add to dashboard Cite

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“…MCI was almost threefold higher in PD patients with RBD compared to those without it (66% vs. 23%; p < 0.001), and subjective cognitive decline was reported in 89% of PD + RBD compared to 58% of those without RBD [ 73 ]. More recent studies reported a prevalence of MCI level I of 12.8% in the lower risk, 21.9% in the higher risk, and 64% in RBD patients, 66% of which had multidomain level II MCI, particularly attention and memory deficits [ 74 ].…”

Section: Epidemiology Of CI In Pdmentioning

confidence: 99%

“…Women experience a worse global cognitive decline during the prodromal phase of PD [ 11 ]. RBD is a cognitive risk factor across individuals of all ages with recently diagnosed PD [ 74 , 86 ]. Increased homocystein levels in peripheral blood are another risk factor for cognitive decline in PD, although no association was found between the polymorphism of genes involved in homocystein metabolism [ 87 ].…”

Section: Risk Factors Of CI In Pdmentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.

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“…In addition, a previous study evaluated a cohort of 412 patients with PD and showed that 209 of them (51%) had trouble with the initiation of sleep or fragmentation during the 5-year study [ 15 ]. Importantly, rapid eye movement (REM) behavior disorder (RBD) is one of the most common sleep disorders observed in PD patients [ 16 , 17 ]. RBD is a parasomnia that is characterized by loss of muscle atonia, and also, abnormal behaviors during the REM phase of sleep, often as dream enactments that may lead to injury [ 18 ].…”

Section: Introduction (Parkinson’s Disease)mentioning

confidence: 99%

Parkinson’s Disease: A Narrative Review on Potential Molecular Mechanisms of Sleep Disturbances, REM Behavior Disorder, and Melatonin

Samizadeh,

Fallah,

Toomarisahzabi

et al. 2023

Brain Sciences

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Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. There is a wide range of sleep disturbances in patients with PD, such as insomnia and rapid eye movement (REM) sleep behavior disorder (or REM behavior disorder (RBD)). RBD is a sleep disorder in which a patient acts out his/her dreams and includes abnormal behaviors during the REM phase of sleep. On the other hand, melatonin is the principal hormone that is secreted by the pineal gland and significantly modulates the circadian clock and mood state. Furthermore, melatonin has a wide range of regulatory effects and is a safe treatment for sleep disturbances such as RBD in PD. However, the molecular mechanisms of melatonin involved in the treatment or control of RBD are unknown. In this study, we reviewed the pathophysiology of PD and sleep disturbances, including RBD. We also discussed the potential molecular mechanisms of melatonin involved in its therapeutic effect. It was concluded that disruption of crucial neurotransmitter systems that mediate sleep, including norepinephrine, serotonin, dopamine, and GABA, and important neurotransmitter systems that mediate the REM phase, including acetylcholine, serotonin, and norepinephrine, are significantly involved in the induction of sleep disturbances, including RBD in PD. It was also concluded that accumulation of α-synuclein in sleep-related brain regions can disrupt sleep processes and the circadian rhythm. We suggested that new treatment strategies for sleep disturbances in PD may focus on the modulation of α-synuclein aggregation or expression.

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Cognitive impairment in REM-sleep behaviour disorder and individuals at risk of Parkinson's disease

Cited by 8 publications

References 19 publications

Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder

Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Parkinson’s Disease: A Narrative Review on Potential Molecular Mechanisms of Sleep Disturbances, REM Behavior Disorder, and Melatonin

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