How does dementia with Lewy bodies start? prodromal cognitive changes in REM sleep behavior disorder

Marchand, Daphné Génier; Postuma, Ronald B.; Escudier, Frédérique; Roy, Jessie De; Pelletier, Amélie; Montplaisir, Jacques; Gagnon, Jean‐François

doi:10.1002/ana.25239

Cited by 81 publications

(86 citation statements)

References 46 publications

(115 reference statements)

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“…Differences in cognitive performance between the PD groups may partly be explained by the PD/RBDþ group evidencing their lowest scores within the domain of attention/working memory, which is known to subserve performance across higher-order functions such as executive functioning and learning. Moreover, previous studies have identified a profile characterized by poor attention in parkinsonian disorders as an important early cognitive feature of patients with RBD who later develop MCI and dementia (Génier Marchand et al, 2018). Together, these results support our hypothesis of a unique cross-sectional association between pRBD and worse cognitive performance in nondemented PD patients, although the direction of this relationship remains unclear.…”

Section: Discussionsupporting

confidence: 89%

“…For example, mild cognitive impairment (MCI) in PD has received more attention as an outcome in recent years (e.g., Aarsland et al, 2017;Pedersen, Larsen, Tysnes, & Alves, 2017;Riedel et al, 2008), as it has been shown to predict later conversion to PD dementia (Kehagia, Barker, & Robbins, 2010) and to be associated with lower quality of life (Lawson et al, 2016;Schiehser et al, 2009). Much of the cognitive literature in parkinsonian disorders has highlighted a profile characterized by poor attention (Génier Marchand et al, 2018;Lawson et al, 2016) and dysexecutive performance (Chahine et al, 2016;Dirnberger & Jahanshahi, 2013;Kudlicka, Clare, & Hindle, 2011;Zgaljardic, Borod, Foldi, & Mattis, 2003;Zgaljardic et al, 2006), but the neuropsychological impairments can be quite heterogeneous (Kehagia et al, 2010). Relatedly, performance-based measures of functional abilities (i.e., medication and financial management) are objective, ecologically valid lab-based assessments of daily living skills that have proven utility in detecting functional deficits in those with PD-MCI (Pirogovsky-Turk et al, 2014).…”

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confidence: 99%

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REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

Mahmood

Patten

Nakhla

et al. 2020

J Int Neuropsychol Soc

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Objective: Rapid eye movement sleep behavior disorder (RBD) affects 33–46% of patients with Parkinson’s disease (PD) and may be a risk factor for neuropsychological and functional deficits. However, the role of RBD on neuropsychological functioning in PD has yet to be fully determined. We, therefore, examined differences in neurocognitive performance, functional capacity, and psychiatric symptoms among nondemented PD patients with probable RBD (PD/pRBD+) and without (PD/pRBD−), and healthy comparison participants (HC). Methods: Totally, 172 participants (58 PD/pRBD+; 65 PD/pRBD−; 49 HC) completed an RBD sleep questionnaire, psychiatric/clinical questionnaires, performance-based and self-reported functional capacity measures, and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function. Results: Controlling for psychiatric symptom severity, the PD/pRBD+ group had poorer executive functioning and learning performance than the PD/pRBD− group and poorer neuropsychological functioning across all individual cognitive domains than the HCs. In contrast, PD/pRBD− patients had significantly lower scores than HCs only in the language domain. Moreover, PD/pRBD+ patients demonstrated significantly poorer medication management skills compared to HCs. Both PD groups reported greater depressive and anxiety severity compared to HCs; PD/pRBD+ group also endorsed greater severity of apathy compared to HCs. Conclusions: The presence of pRBD is associated with poorer neuropsychological functioning in PD such that PD patients with pRBD have poorer cognitive, functional, and emotional outcomes compared to HC participants and/or PD patients without pRBD. Our findings underscore the importance of RBD assessment for improved detection and treatment of neuropsychological deficits (e.g., targeted cognitive interventions).

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

Mahmood

Patten

Nakhla

et al. 2020

J Int Neuropsychol Soc

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“…Recent RBD studies also traced prodromal cognitive loss (i.e., prodromal DLB), finding that the earliest abnormalities to appear were attention and executive functions, already present at diagnosis . These were followed by verbal episodic learning and memory deficits, which started to deviate from normal 5 to 6 years before dementia diagnosis, becoming clinically significant at 1 to 2 years before diagnosis . Overall, these clinical RBD studies generally recapitulated the proposed pathological staging models, thereby allowing direct clinical confirmation of a central model of PD pathogenesis.…”

Section: Key Advances In the Last Decadementioning

confidence: 62%

“…Olfactory loss had even a longer prodromal interval, estimated at 22 years . Recent RBD studies also traced prodromal cognitive loss (i.e., prodromal DLB), finding that the earliest abnormalities to appear were attention and executive functions, already present at diagnosis . These were followed by verbal episodic learning and memory deficits, which started to deviate from normal 5 to 6 years before dementia diagnosis, becoming clinically significant at 1 to 2 years before diagnosis .…”

Section: Key Advances In the Last Decadementioning

confidence: 99%

Prodromal Parkinson's Disease: The Decade Past, the Decade to Come

2019

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The past decade has seen a dramatic expansion of the field of prodromal PD. Ten years ago, there were only six known prodromal markers of disease, none of which had more than two studies documenting diagnostic value. We now have at least 16 markers, with as many as 10 prospective studies for a single marker. This review summarizes the major advances over the last decade and speculates about the advances we will see in the decade to come. The most notable advances over the last decade came through the study of high‐risk cohorts (REM sleep behavior disorder and later genetic and autonomic cohorts), the generation of more representative population‐based cohorts for studying prodromal PD, major advances in neuroimaging of early disease stages, the emerging likelihood that tissue biopsy will be able to diagnose prodromal PD, and the coalescence of prodromal markers into discrete criteria. As the next decade dawns, we await increasing precision of sensitivity and specificity estimates of known markers, the discovery of new biomarkers of prodromal disease, improvements in diagnosis using combined methods/criteria (with increasing recognition of prodromal PD as one stage of the full PD spectrum), and ultimately the development of neuroprotective therapy that can be provided at the earliest stages of disease. © 2019 International Parkinson and Movement Disorder Society

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“…Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is a parasomnia characterized by dream‐enacting behavior during REM sleep, which is not associated with other neurological diseases. Several studies have shown that verbal memory, visuospatial and executive dysfunctions exist and progress in iRBD patients . Hyposmia is a prodromal biomarker of Lewy body diseases (LBDs) which is also frequent in iRBD patients , and it is predictive of impending disease conversion to LBD .…”

Section: Introductionmentioning

confidence: 99%

Cognitive decline in association with hyposmia in idiopathic rapid eye movement sleep behavior disorder: a prospective 2‐year follow‐up study

Shin

Lee

Kim

et al. 2019

Euro J of Neurology

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Background and purpose The aim was to analyze the characteristics and progression of cognitive dysfunction in non‐demented idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with baseline olfactory function. Methods From a prospective polysomnography‐confirmed iRBD cohort, 25 patients (16 patients in 2‐year follow‐up) and 13 normal controls were included. Initial and 2‐year follow‐up cognitive functions were analyzed with olfactory function and 18F‐fluorinated‐N‐3‐fluoropropyl‐2β‐carboxymethoxy‐3β‐(4‐iodophenyl)‐nortropane (18F‐FP‐CIT) uptake in deep nuclei initially. Results Idiopathic RBD patients had impaired attention, memory and executive function compared to controls. Baseline cognitive tests were comparable between the iRBD subgroups with and without hyposmia. 18F‐FP‐CIT uptake tended to be lower in the hyposmic group than in the normosmic group. The olfactory test score was positively correlated with amygdala uptake in iRBD patients (P = 0.027). After 2 years, visuospatial and verbal memory dysfunction worsened more in hyposmics than in normosmics. Lower initial olfactory test score was associated with more severe declines in verbal memory function. Conclusions Hyposmia may be a predictive sign of cognitive decline in iRBD patients.

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How does dementia with Lewy bodies start? prodromal cognitive changes in REM sleep behavior disorder

Cited by 81 publications

References 46 publications

REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

Prodromal Parkinson's Disease: The Decade Past, the Decade to Come

Cognitive decline in association with hyposmia in idiopathic rapid eye movement sleep behavior disorder: a prospective 2‐year follow‐up study

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