Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Bugalho, Paulo; Salavisa, Manuel

doi:10.5664/jcsm.8086

Cited by 15 publications

(16 citation statements)

References 33 publications

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“…37 If the motor activity during REM sleep is more vigorous in men, 38,39 then it is possible that RBD may be noticed earlier in men. The underlying pathophysiology for such a difference is not understood, but increased REM sleep-phasic muscle activity in men, [40][41][42] and sex differences in the types of motor movements 40 may be contributing factors. Although RBD is a strong predictor of probable DLB, 17,18,36 it is possible that a more subtle expression of RBD, perhaps more common in women, may be under-reported or unrecognized without routine polysomnography.…”

Section: Discussionmentioning

confidence: 99%

The temporal onset of the core features in dementia with Lewy bodies

Choudhury

Graff‐Radford

Aakre

et al. 2021

Alzheimer's & Dementia

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Introduction:We examined the temporal sequence of the core features in probable dementia with Lewy bodies (DLB). Methods:In 488 patients with probable DLB, the onset of each core feature and time to diagnosis was determined for men and women, and a pathologic subgroup (n = 209).Results: REM sleep behavior disorder (RBD) developed before the other core features in men and women. Men were more likely to have RBD and were diagnosed with probable DLB earlier than women. Visual hallucinations developed after the other core features in men, but in women, they appeared earlier and concurrently with fluctuations and parkinsonism. Women were older and more cognitively impaired at first visit, were less likely to have RBD, more likely to be diagnosed with probable DLB later than men, and more likely to have neocortical tangles.Discussion: An earlier latency to probable DLB was associated with men, RBD, and Lewy body disease without neocortical tangles.

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Section: Discussionmentioning

confidence: 99%

The temporal onset of the core features in dementia with Lewy bodies

Choudhury

Graff‐Radford

Aakre

et al. 2021

Alzheimer's & Dementia

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“…In line with this, a polysomnographic study investigating motor features of sleep behaviours reported that men have higher EMG phasic activity, more myoclonic movements, and more movements involving the trunk, whereas segmental movements were more frequent in women (Bugalho & Salavisa, 2019). Another polysomnographic study investigating RWA in both legs and arms, reported a higher RWA index in the legs in men compared with women, and a higher RWA index in the arms in women.…”

Section: Sex Issues Inrbdmentioning

confidence: 70%

Rapid eye movement sleep behaviour disorder: Past, present, and future

Högl

Arnulf

Bergmann

et al. 2022

Journal of Sleep Research

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Summary This manuscript presents an overview of REM sleep behaviour disorder (RBD) with a special focus on European contributions. After an introduction examining the history of the disorder, we address the pathophysiological and clinical aspects, as well as the diagnostic issues. Further, implications of RBD diagnosis and biomarkers are discussed. Contributions of European researchers to this field are highlighted.

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“…Bugalho and Salavisa reported the influence of referral reason for RBD diagnosis on the global severity of motor events during REM sleep. 26 Patients who were directly referred because of RBD symptoms showed a higher severity of motor events during REM sleep than did those with RBD who were referred after screening procedure or during clinical follow-up for other disorders. In most of our patients, RBD symptoms were identified after screening procedures for the differential diagnosis of DLB in memory clinics.…”

Section: Importance Of Proactive and Comprehensive Sleep History Evaluationmentioning

confidence: 89%

“…The authors emphasised the potential selection bias in different clinical settings. Bugalho and Salavisa reported the influence of referral reason for RBD diagnosis on the global severity of motor events during REM sleep 26 . Patients who were directly referred because of RBD symptoms showed a higher severity of motor events during REM sleep than did those with RBD who were referred after screening procedure or during clinical follow‐up for other disorders.…”

Section: Discussionmentioning

confidence: 99%

Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac ¹²³I‐MIBG scintigraphy in memory clinics

Fujishiro

Ota²,

Yamagata³

et al. 2021

Psychogeriatrics

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Background Rapid eye movement sleep behaviour disorder (RBD) is associated with reduced cardiac 123I‐metaiodobenzylguanidine (MIBG) uptake and often precedes the onset of Lewy body (LB) disorders. We investigated the role of cardiac 123I‐MIBG scintigraphy in relation to probable RBD for the clinical diagnosis of prodromal dementia with Lewy bodies (DLB) in memory clinics. Methods We reviewed clinical profiles of 60 consecutive patients who underwent cardiac 123I‐MIBG scintigraphy in our memory clinics. The diagnostic threshold of 2.20 was used as the cut‐off for the heart‐to‐mediastinum ratio at the delayed phase. Results Cardiac 123I‐MIBG abnormality was identified in 28 patients at baseline; six were cognitively unimpaired, six had mild cognitive impairment (MCI)‐LB, and 16 had probable DLB based on the National Institute on Aging and Alzheimer's Association Research Framework. Although the number of core features increased in accordance with the progression of three cognitive categories, there were no differences in the prevalence of probable RBD and the cardiac MIBG scintigraphy indices among them. During the observation period, two cognitively unimpaired patients with probable RBD progressed to MCI‐LB, and three MCI‐LB patients with probable RBD developed DLB. The prevalence of final diagnosis of probable MCI‐LB or DLB was significantly higher in these patients (85%) than the remaining 32 patients without (9%). Of 25 patients with probable RBD, 22 (88%) had a cardiac 123I‐MIBG abnormality regardless of cognitive conditions. Only one patient consulted a sleep centre for the abnormal sleep behaviour before visiting our memory clinics. Regarding the gender differences, male predominance was not identified and sleep‐related injury more frequently occurred in men (7/12, 58%) than in women (1/10, 10%). Conclusions Proactive detection of probable RBD plus cardiac 123I‐MIBG abnormality provides the opportunity for an early diagnosis of prodromal DLB in memory clinics. This approach warrants further follow‐up studies with polysomnographic and pathological verification.

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Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Cited by 15 publications

References 33 publications

The temporal onset of the core features in dementia with Lewy bodies

The temporal onset of the core features in dementia with Lewy bodies

Rapid eye movement sleep behaviour disorder: Past, present, and future

Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac ¹²³I‐MIBG scintigraphy in memory clinics

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Factors Influencing the Presentation of REM Sleep Behavior Disorder: The Relative Importance of Sex, Associated Neurological Disorder, and Context of Referral to Polysomnography

Cited by 15 publications

References 33 publications

The temporal onset of the core features in dementia with Lewy bodies

The temporal onset of the core features in dementia with Lewy bodies

Rapid eye movement sleep behaviour disorder: Past, present, and future

Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac 123I‐MIBG scintigraphy in memory clinics

Contact Info

Product

Resources

About

Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac ¹²³I‐MIBG scintigraphy in memory clinics