REM sleep behavior disorder predicts functional dependency in early Parkinson's disease

Kim, Ryul; Yoo, Dallah; Im, Jin Hee; Kim, Han Joon; Jeon, Beomseok

doi:10.1016/j.parkreldis.2019.07.025

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…Indeed, RBD in patients with PD has a pervasive influence on both motor and non-motor symptoms (Pagano et al, 2018 ; Kim et al, 2019 ; Liu et al, 2020 ), which provides evidence for the poor prognosis for this disease. Consistently, this work found that patients with PD-pRBD + exhibited a more rapid decline in striatal dopamine transporter binding and cognition, greater daytime sleepiness, and worse disease staging than patients with PD-pRBD − as the disease progressed.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbances are frequently experienced in patients with Parkinson's disease (PD) (Fereshtehnejad et al, 2017 ; Jozwiak et al, 2017 ). Specifically, rapid eye movement (REM) sleep behavior disorder (RBD) affects 30–40% of PD (Sixel-Döring et al, 2016 ), which is associated with early neuropathological progression of this disease (Muzur et al, 2002 ; Vendette et al, 2007 ; Kim and Jeon, 2014 ; Pagano et al, 2018 ; Kim et al, 2019 , 2020 ; Figorilli et al, 2020 ). However, the pathophysiology of RBD in PD is still widely unknown.…”

Section: Introductionmentioning

confidence: 99%

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Progressive Prefrontal Cortex Dysfunction in Parkinson's Disease With Probable REM Sleep Behavior Disorder: A 3-Year Longitudinal Study

Jia

Fan

Wang

et al. 2022

Front. Aging Neurosci.

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This study aimed to explore the disrupted prefrontal cortex activity specific to patients with Parkinson's disease (PD) with rapid eye movement sleep behavior disorder (RBD) compared with those without and to further examine the associations between these alterations and neuropsychological measurements. Ninety-six patients with early PD underwent both structural and functional MRI, and also neuropsychological assessments in the Parkinson's Progression Markers Initiative (PPMI) database. Of these, 46 patients who completed 1- and 3-year fMRI follow-up examinations were categorized as PD with probable RBD (PD-pRBD+) and without (PD-pRBD−). The left dorsolateral prefrontal cortex (DLPFC) seed-to-voxel functional connectivity analysis was conducted to evaluate the progressive neural alterations specific to PD-pRBD+ compared with PD-pRBD− over time. Furthermore, relationships between these alterations and neuropsychological performance were examined. Compared with patients with PD-pRBD−, patients with PD-pRBD+ initially exhibited connectivity deficits between the left DLPFC and the medial frontopolar cortex. Moreover, these patients further exhibited disrupted DLPFC connectivity in the lateral frontopolar cortex at the 3-year follow-up evaluation. Correlation analysis revealed that connectivity between the left DLPFC and frontopolar cortex was positively related to executive function in PD-pRBD+ after adjusting for nuisance variables. Progressive prefrontal cortex dysfunction associated with RBD in early PD may provide an effective subtype-specific biomarker of neurodegenerative progression, which may shed light on the neuropathological mechanisms underlying the clinical heterogeneity of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Progressive Prefrontal Cortex Dysfunction in Parkinson's Disease With Probable REM Sleep Behavior Disorder: A 3-Year Longitudinal Study

Jia

Fan

Wang

et al. 2022

Front. Aging Neurosci.

View full text Add to dashboard Cite

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“…A score of five or above was regarded as abnormal [ 51 ]. The Epworth sleepiness scale (ESS) for assessing daytime sleepiness includes an eight-question questionnaire scoring between 0 and 24; the higher the score, the higher the chances of dozing off [ 52 , 53 ]. A cutoff above ten was considered pathological sleepiness.…”

Section: Methodsmentioning

confidence: 99%

A Comprehensive Assessment of Qualitative and Quantitative Prodromal Parkinsonian Features in Carriers of Gaucher Disease—Identifying Those at the Greatest Risk

Becker‐Cohen

Zimran

Dinur

et al. 2022

IJMS

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Carriers of GBA1 gene variants have a significant risk of developing Parkinson’s disease (PD). A cohort study of GBA carriers between 40–75 years of age was initiated to study the presence of prodromal PD features. Participants underwent non-invasive tests to assess different domains of PD. Ninety-eight unrelated GBA carriers were enrolled (43 males) at a median age (range) of 51 (40–74) years; 71 carried the N370S variant (c.1226A > G) and 25 had a positive family history of PD. The Montreal Cognitive Assessment (MoCA) was the most frequently abnormal (23.7%, 95% CI 15.7–33.4%), followed by the ultrasound hyperechogenicity (22%, 95% CI 14–32%), Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) (17.2%, 95% CI 10.2–26.4%), smell assessment (12.4%, 95% CI 6.6–20.6%) and abnormalities in sleep questionnaires (11%, 95% CI 5.7–19.4%). Significant correlations were found between tests from different domains. To define the risk for PD, we assessed the bottom 10th percentile of each prodromal test, defining this level as “abnormal”. Then we calculated the percentage of “abnormal” tests for each subject; the median (range) was 4.55 (0–43.5%). Twenty-two subjects had more than 15% “abnormal” tests. The limitations of the study included ascertainment bias of individuals with GBA-related PD in relatives, some incomplete data due to technical issues, and a lack of well-characterized normal value ranges in some tests. We plan to enroll additional participants and conduct longitudinal follow-up assessments to build a model for identifying individuals at risk for PD and investigate interventions aiming to delay the onset or perhaps to prevent full-blown PD.

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“…Sleep behavior disorders could serve as prodromal markers with a high risk for predicting neurodegeneration, and there has been a strong correlation with depression (Postuma et al, 2013). The presence of RBD in early PD patients may be a key determinant of increased risk of functional dependency, which indicated that RBD portended an unfavorable prognosis in Parkinson's processes (Kim et al, 2019). We constructed the RBD prognostic model that could detect conversion from RBD-negativity to RBD-positivity with moderate accuracy.…”

Section: Discussionmentioning

confidence: 99%

Multi-predictor modeling for predicting early Parkinson’s disease and non-motor symptoms progression

Dou

Zhang

et al. 2022

Front. Aging Neurosci.

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BackgroundIdentifying individuals with high-risk Parkinson’s disease (PD) at earlier stages is an urgent priority to delay disease onset and progression. In the present study, we aimed to develop and validate clinical risk models using non-motor predictors to distinguish between early PD and healthy individuals. In addition, we constructed prognostic models for predicting the progression of non-motor symptoms [cognitive impairment, Rapid-eye-movement sleep Behavior Disorder (RBD), and depression] in de novo PD patients at 5 years of follow-up.MethodsWe retrieved the data from the Parkinson’s Progression Markers Initiative (PPMI) database. After a backward variable selection approach to identify predictors, logistic regression analyses were applied for diagnosis model construction, and cox proportional-hazards models were used to predict non-motor symptom progression. The predictive models were internally validated by correcting measures of predictive performance for “optimism” or overfitting with the bootstrap resampling approach.ResultsFor constructing diagnostic models, the final model reached a high accuracy with an area under the curve (AUC) of 0.93 (95% CI: 0.91–0.96), which included eight variables (age, gender, family history, University of Pennsylvania Smell Inventory Test score, Montreal Cognitive Assessment score, RBD Screening Questionnaire score, levels of cerebrospinal fluid α-synuclein, and SNCA rs356181 polymorphism). For the construction of prognostic models, our results showed that the AUC of the three prognostic models improved slightly with increasing follow-up time. The overall AUCs fluctuated around 0.70. The model validation established good discrimination and calibration for predicting PD onset and progression of non-motor symptoms.ConclusionThe findings of our study facilitate predicting the individual risk at an early stage based on the predictors derived from these models. These predictive models provide relatively reliable information to prevent PD onset and progression. However, future validation analysis is still needed to clarify these findings and provide more insight into the predictive models over more extended periods of disease progression in more diverse samples.

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REM sleep behavior disorder predicts functional dependency in early Parkinson's disease

Cited by 9 publications

References 28 publications

Progressive Prefrontal Cortex Dysfunction in Parkinson's Disease With Probable REM Sleep Behavior Disorder: A 3-Year Longitudinal Study

Progressive Prefrontal Cortex Dysfunction in Parkinson's Disease With Probable REM Sleep Behavior Disorder: A 3-Year Longitudinal Study

A Comprehensive Assessment of Qualitative and Quantitative Prodromal Parkinsonian Features in Carriers of Gaucher Disease—Identifying Those at the Greatest Risk

Multi-predictor modeling for predicting early Parkinson’s disease and non-motor symptoms progression

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