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

Abstract

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).

Analysis of Influencing Factors of Apathy in Patients with Parkinson’s Disease

“…Studies by Bargiotas et al [ 37 ] found that patients with PD who have RBD had a higher probability of developing apathy and higher AS scores, thus indicating that RBD may be a potential risk factor for apathy. This is consistent with the conclusion of Mahmood et al [ 38 ]. Because it is relatively easy to identify RBD in the early stages of the disease or even in the prodromal stage, its presence may facilitate early clinical identification of apathetic patients.…”

Effects of cognitive ageing trajectories on multiple adverse outcomes among Chinese community-dwelling elderly population

“…However, even if increasing evidence have demonstrated the detrimental effect of a rapid cognitive decline on several adverse events with this method, including functional disability, hospitalization, nursing home admission, regional brain atrophy, and mortality [14][15][16], most existing studies failed to take initial cognitive function into account [14,15]. Furthermore, although cognitive deterioration has been reported to be associated with several functional deficits such as frailty [17], falls [18], rapid eye movement behavior disorders (RBD) [19], depression [20], motor cognitive risk syndrome (MCR) [21] and etc., it remains undetermined whether cognitive ageing trajectory is associated with these functional deficits as well. Likewise, previous efforts which probed into factors shaping cognitive ageing trajectories were limited by small sample size, specific risk factors, or conflicting results primarily from western populations [8,9,11,[22][23][24].…”

Decoding Prodromal Parkinson’s Disease: Clinical Differences between Isolated Hyposmia and REM Sleep Behavior Disorder

“…Previous studies on the prodromal phase have focused only on individuals with iRBD, omitting those without iRBD (35,36). This approach misses a significant subset of PD patients who will never have iRBD, thereby limiting a comprehensive understanding of the prodromal phase (37,38). Our study addresses this gap by incorporating a hyposmic cohort, enriched by the prerequisite of abnormal DAT-SPECT imaging for enrolment.…”