Rhythm disturbances as a potential early marker of Parkinson’s disease in idiopathic REM sleep behavior disorder

Abstract

Objective We aimed to identify timing distortions in production and perception of rhythmic events in patients with idiopathic REM sleep behavior disorder (iRBD) as early markers of Parkinson's disease (PD). Methods Rhythmic skills, clinical characteristics, dysautonomia, depression, and olfaction were compared in 97 participants, including 21 participants with iRBD, 38 patients with PD, and 38 controls, matched for age, gender, and education level. Rhythmic disturbances can be easily detected with dedicated motor tasks via a tablet application. Rhythm production was tested in two conditions: to examine the ability to generate a spontaneous endogenous rhythm, tapping rate and variability in a finger tapping task without external stimulation was measured, while the ability to synchronize to an external rhythm was tested with finger tapping to external auditory cues. Rhythm perception was measured with a task, in which the participants had to detect a deviation from a regular rhythm. Participants with iRBD had dopamine transporter imaging. Results Participants with iRBD and PD revealed impaired spontaneous rhythm production and poor rhythm perception compared to controls. Impaired rhythm production was correlated with olfaction deficits, dysautonomia, impaired non‐motor aspects of daily living, and dopamine uptake measures. Conclusions Participants with iRBD show impaired rhythm production and perception; this impairment is correlated with other early markers for PD. Testing rhythmic skills with short and inexpensive tests may be promising for screening for potential future PD in iRBD patients.

Classifying Idiopathic Rapid Eye Movement Sleep Behavior Disorder, Controls, and Mild Parkinson's Disease Using Gait Parameters

“…Cadence and phase difference were also involved, suggesting a rhythmicity dysfunction. This is in line with our recent results suggesting rhythm disturbances as a potential early marker of PD 26 …”

“…This is in line with our recent results suggesting rhythm disturbances as a potential early marker of PD. 26 The main limitations of our study are the low sample size and the cross-sectional rather than longitudinal design of the study, which calls for further investigation in a larger population and in a longitudinal way. We could also have used more challenging dual tasks.…”

At-Home Training With a Rhythmic Video Game for Improving Orofacial, Manual, and Gait Abilities in Parkinson’s Disease: A Pilot Study

“…Beyond cardinal motor symptoms of Parkinson’s disease (PD), severe rhythm deficits encompassing different motor domains are consistently reported, potentially representing an early marker of the disease ( Cochen De Cock et al, 2020 ). These deficits manifest in heightened rhythmic variability of upper-limb, orofacial, and gait coordination ( Skodda et al, 2010 ; Dalla Bella et al, 2017 ; Lowit et al, 2018 ).…”

The effects of Parkinson’s disease, music training, and dance training on beat perception and production abilities

“…Similar trends of impaired temporal discrimination performance are observed among healthy adults when dopamine uptake is disrupted by dopamine receptor antagonists [ 10 ]. Furthermore, beat perception and production deficits are correlated with idiopathic REM sleep disorder which commonly occurs prior to Parkinson’s disease onset and is often considered a prodromal-Parkinson’s disease symptom [ 11 ]. These studies confirm the crucial role of dopamine in timing and rhythm processing.…”