REM sleep behaviour disorder is associated with worse quality of life and other non-motor features in early Parkinson's disease

Abstract

BackgroundConcomitant REM sleep behaviour disorder (RBD) is commonly observed in patients with Parkinson's disease (PD). Although the brainstem structures responsible for the symptoms of RBD correspond to the premotor stages of PD, the association of RBD with motor and non-motor features in early PD remains unclear.MethodsThe study evaluated 475 patients with PD within 3.5 years of diagnosis for the presence of probable RBD (pRBD) using the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ). A neurologist and a trained research nurse carried out evaluation of each participant blinded to the results of the RBDSQ. Standardised rating scales for motor and non-motor features of PD, as well as health-related quality of life measures, were assessed. Multiple linear and logistic regression analyses were used to determine the relationship between pRBD and a variety of outcomes, controlling for confounding factors.ResultsThe overall frequency of pRBD was 47.2% (95% CI 42.7% to 51.9%). None of the patients had a previous diagnosis of RBD. Patients with PD and concomitant pRBD did not differ on motor phenotype and scored comparably on the objective motor scales, but reported problems with motor aspects of daily living more frequently. Adjusted for age, sex, disease duration and smoking history, pRBD was associated with greater sleepiness (p=0.001), depression (p=0.001) and cognitive impairment (p=0.006).ConclusionspRBD is common and under-recognised in early PD. It is associated with increased severity and frequency of non-motor features, poorer subjective motor performance and a greater impact on health-related quality of life.

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

“…Contrary to sleep clinics, in this study, all participants were screened for dream enactment regardless of severity, removing much of this bias. Our finding is consistent with studies in PD which also actively screen for RBD and show smaller differences in prevalence in men vs. women [37,38]. It appears thus that the strong sex differences seen in sleep centers are at least partially artifactual and illustrate the advantages of population-based studies for studying risk factors for disease.…”

Paired neurophysiological and clinical study of the brainstem at different stages of Parkinson’s Disease

“…Although not diagnostic, RBD-SQ is a reliable screening test for the presence of symptoms of RBD (Nomura et al, 2011;Rolinski et al, 2012), a non-motor symptom which is now acknowledged as a risk factor for the future development of a number of neurodegenerative disorders, PD being the most common (Postuma et al, 2012). The consistent correlation between RBD-SQ and VEMPs was found in early as well as late PD.…”

Detection of alpha‐synuclein conformational variants from gastro‐intestinal biopsy tissue as a potential biomarker for Parkinson's disease

“…Full details of the protocols have been described previously 29. Briefly, validated questionnaires were used to assess and quantify a range of clinical items in this cohort including: motor function (MDS UPDRS part III); cognitive impairment (MMSE); constipation (Honolulu‐Asia Ageing Study Constipation Questionnaire); hyposmia (the 16‐stick Sniffin odour identification test); RBD (Epworth Sleepiness Scale and RBD Screening Questionnaire).…”