Postural sway in idiopathic rapid eye movement sleep behavior disorder: A potential marker of prodromal Parkinson׳s disease

Chen, Tuanzhi; Xu, Guangjun; Guang-an, Zhou; Wang, Jingru; Chan, Piu; Du, Yifeng

doi:10.1016/j.brainres.2014.02.040

Cited by 29 publications

(23 citation statements)

References 31 publications

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“…This experiment provides quantitative evidence that people with RBD can present with subliminal changes in the kinetics and EMG patterns of gait initiation prior to the clinical expression of parkinsonian symptoms . Distinct deficits in the posterior shift of the CoP were observed during both the anticipatory and propulsive phases of gait initiation.…”

Section: Discussionmentioning

confidence: 78%

Subliminal gait initiation deficits in rapid eye movement sleep behavior disorder: A harbinger of freezing of gait?

et al. 2016

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Background Muscle activity during REM sleep is markedly increased in people with REM sleep behavior disorder (RBD) and people with Parkinson’s disease (PD) who have freezing of gait. This study examined if individuals with RBD, who do not have a diagnosis of PD, show abnormalities in gait initiation that resemble the impairments observed in PD and whether there is a relationship between these deficits and the level of REM sleep without atonia. Methods Gait initiation and polysomnography studies were conducted in four groups of 10 subjects each: RBD, PD with and without freezing of gait and control subjects. Results Significant reductions were seen in the posterior shift of the center of pressure during the propulsive phase of gait initiation in the RBD and PD with freezing of gait groups compared with controls and PD non-freezers. These reductions negatively correlated with the amount of REM sleep without atonia. The duration of the initial dorsiflexor muscle burst during gait initiation was significantly reduced in both PD groups and the RBD cohort. Conclusions These results provide evidence that people with RBD, prior to a diagnosis of a degenerative neurologic disorder, show alterations in the coupling of posture and gait similar to those seen in PD. The correlation between increased REM sleep without atonia and deficits in forward propulsion during the push-off phase of gait initiation suggests that abnormities in the regulation of muscle tone during REM sleep may be related to the pathogenesis of freezing of gait.

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Section: Discussionmentioning

confidence: 78%

Subliminal gait initiation deficits in rapid eye movement sleep behavior disorder: A harbinger of freezing of gait?

et al. 2016

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“…This finding is particularly noteworthy, as postural imbalance is not expected to be clinically overt until the later stages of PD [ 11 , 23 ]. Moreover, given that subclinical deficits in postural stability have been noted in early PD [ 11 , 12 ], similar findings of increased postural sway in patients with rapid eye movement sleep behavior disorder may indicate balance impairments in prodromal PD, as more than half of these patients are expected to eventually develop parkinsonism (PD, multiple system atrophy, or Lewy body dementia) [ 15 ]. Such subtle deficits could conceivably translate into increased risks of falling and consequent injury in prodromal PD, but, to our knowledge, only one previous study [ 13 ] has addressed this question.…”

Section: Discussionmentioning

confidence: 99%

“…However, this staging relies on the clinical evaluation of balance. Quantitative measurements of postural stability have detected abnormalities also in the early stages of PD [ 11 , 12 ], and recent findings suggest that balance can be impaired in the prodromal phase of the disease [ 13 – 15 ]. Whether such subclinical deficits increase the risk of falling remains unclear, but a high incidence of accidental injuries in the years preceding PD diagnosis has been reported [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case–Control Studies in a Nationwide Cohort

Nyström

Nordström

2016

PLoS Med

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BackgroundLow muscle strength has been found in late adolescence in individuals diagnosed with Parkinson disease (PD) 30 y later. This study investigated whether this lower muscle strength also may translate into increased risks of falling and fracture before the diagnosis of PD.Methods and FindingsAmong all Swedish citizens aged ≥50 y in 2005, two nested case–control cohorts were compiled. In cohort I, individuals diagnosed with PD during 1988–2012 (n = 24,412) were matched with up to ten controls (n = 243,363), and the risk of fall-related injuries before diagnosis of PD was evaluated. In cohort II, individuals with an injurious fall in need of emergency care during 1988–2012 (n = 622,333) were matched with one control (n = 622,333), and the risk of PD after the injurious fall was evaluated. In cohort I, 18.0% of cases and 11.5% of controls had at least one injurious fall (p < 0.001) prior to PD diagnosis in the case. Assessed by conditional logistic regression analysis adjusted for comorbid diagnoses and education level, PD was associated with increased risks of injurious fall up to 10 y before diagnosis (odds ratio [OR] 1.19, 95% CI 1.08–1.31; 7 to <10 y before diagnosis) and hip fracture ≥15 y before diagnosis (OR 1.36, 95% CI 1.10–1.69; 15–26 y before diagnosis). In cohort II, 0.7% of individuals with an injurious fall and 0.5% of controls were diagnosed with PD during follow-up (p < 0.001). The risk of PD was increased for up to 10 y after an injurious fall (OR 1.18, 95% CI 1.02–1.37; 7 to <10 y after diagnosis). An important limitation is that the diagnoses were obtained from registers and could not be clinically confirmed for the study.ConclusionsThe increased risks of falling and hip fracture prior to the diagnosis of PD may suggest the presence of clinically relevant neurodegenerative impairment many years before the diagnosis of this disease.

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“…As well as the sleep disorder, the RBD prodrome of PD includes objective motor and non‐motor deficits, with impaired balance (Chen et al., ), abnormal gait (Alibiglou, Videnovic, Planetta, Vaillancourt, & MacKinnon, ; Videnovic et al., ) and other fine and gross motor slowing (Postuma, Gagnon, Vendette, & Montplaisir, ). Postuma et al.…”

Section: Rem Sleep Behaviour Disordermentioning

confidence: 99%

The prodromes of Parkinson's disease

Rees

Noyce

Schrag

2018

Eur J of Neuroscience

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Whilst the diagnosis of Parkinson's disease (PD) relies on the motor triad of bradykinesia, rigidity and tremor, the underlying pathological process starts many years before these signs are overt. In this prodromal phase of PD, a diverse range of non‐motor and motor features can occur. Individually they do not allow a diagnosis of PD, but when considered together, they reflect the gradual development of the clinical syndrome. Different subgroups within the prodromal phase may exist and reflect different underlying pathology. Here, we summarise the evidence on the prodromal phase of PD in patient groups at increased risk of PD with well described prodromal features: patients with idiopathic rapid eye movement sleep behaviour disorder, patients with idiopathic anosmia and families with monogenic mutations that are closely linked to PD pathology. In addition, we discuss the information on prodromal features from ongoing studies aimed at detecting prodromal PD in the general population. It is likely that better delineation of the clinical prodromes of PD and their progression in these high‐risk groups will improve understanding of the underlying pathophysiology.

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Postural sway in idiopathic rapid eye movement sleep behavior disorder: A potential marker of prodromal Parkinson׳s disease

Cited by 29 publications

References 31 publications

Subliminal gait initiation deficits in rapid eye movement sleep behavior disorder: A harbinger of freezing of gait?

Subliminal gait initiation deficits in rapid eye movement sleep behavior disorder: A harbinger of freezing of gait?

Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case–Control Studies in a Nationwide Cohort

The prodromes of Parkinson's disease

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