A case–control–family study of idiopathic rapid eye movement sleep behavior disorder

Liu, Yaping; Zhang, Jihui; Lam, Siu Ping; Zhou, Junying; Yu, Manda; Li, Shirley Xin; Chan, Joey Wing Yan; Postuma, Ronald B.; Mok, Vincent Chung Tong; Wing, Yun Kwok

doi:10.1002/ana.25435

Cited by 20 publications

(34 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only 1 patient had past history of benzodiazepine abuse, 2 patients of alcohol and one of cocaine abuse. Literature shows that one of the RBD-subgroups can be middle-aged women with autoimmune disease [ 11 ], but we did not find any association between RSWA and history of autoimmune disease in our patients’ cohort, as well as in positive perinatal history or family history of mental diseases [ 30 ]. Because other studies confirm several risk factors for RBD in general population [ 26 , 31 ], we hypothesized that it could reflect the epidemiological heterogeneity of RSWA/RBD.…”

Section: Discussioncontrasting

confidence: 65%

Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

et al. 2020

View full text Add to dashboard Cite

Background Isolated REM sleep without atonia (RSWA) as a main polysomnograhic feature of REM sleep behaviour disorder (RBD) is thought to be a prodromal or subclinical state of the disease. RSWA/RBD occurence in psychiatric population is much more frequent than in general population but its associated factors are still not known. Methods We invited 88 psychiatry in-patients to undervent video-polysomnography. The visual scoring was focused on RSWA in submentales and flexores digitales superficiales muscles. This parametr was subsequently correlated mainly with age/gender, their medication and mental status. Results The RWSA was mostly still in normal range despite the fact, that selected psychiatry patients (≤ 50 years) were taking several classes of psychoactive medication. 3,6% had convincingly RBD, although 35.7% reported rare lifetime occurence of dream-enacting behaviour and 62.8% sporadic nightmares. We found correlation between RSWA and SNRI medication class (p = 0.015), specifically venlafaxine (p = 0.029) as well as quetiapine (p = 0.030). Another significant associated factors were current anxiety (p < 0.001) and depressive symptoms (p = 0.05), but we found no relation between RSWA and given diagnosis. Conlucions Isolated RSWA in younger psychiatry patients might be a result of multiple factors, including medication and current mental status but these factors are in most cases not sufficient to manifest RBD.

show abstract

Section: Discussioncontrasting

confidence: 65%

Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Patients with clinically diagnosed α‐synucleinopathies and patients with iRBD meeting the selection criteria were selected from a cohort of Hong Kong Chinese patients with iRBD (see Fig 1). Please refer to our previous studies regarding the profiles of this cohort 1,20 . Non‐rapid eye movement (REM) sleep behavior disorder (RBD) controls were recruited from the community 1 …”

Section: Methodsmentioning

confidence: 99%

“…Increasing studies have suggested idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) as a prodromal stage of α‐synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA) 1,2 . iRBD is currently recognized as the strongest prodromal marker (likelihood ratio = 130) among 25 prodromal risk markers (likelihood ratio of other markers range from 1.2 to 43.3) in predicting the onset of prodromal PD 3 .…”

mentioning

confidence: 99%

Rest‐Activity Pattern Alterations in Idiopathic REM Sleep Behavior Disorder

Feng

Chen

Liu

et al. 2020

Annals of Neurology

Self Cite

View full text Add to dashboard Cite

The purpose of this study was to investigate the differences in actigraphy-measured rest-activity patterns (eg, sleep-wake cycle, circadian rest-activity rhythm, and physical activity) across different stages of α-synucleinopathy. Methods: We compared alterations in 7-day actigraphy-measured rest-activity patterns among patients with clinically diagnosed α-synucleinopathies (n = 44), and their age-, sex-, and body mass index (BMI)-matched patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, n = 88), and non-rapid eye movement (REM) sleep behavior disorder (RBD) controls (n = 44) in a case-control study (study 1) and between convertors (n = 22) and their age-, sex-, BMI-, iRBD-duration, and follow-up duration-matched non-convertors (n = 66) in a prospective nested casecontrol study (study 2). Results: In study 1, there were significant increases (all p values were adjusted by false discovery rate < 0.01) in probable napping behaviors (percentage, duration, and episodes), activity fragmentation (estimated by k AR), and physical inactivity during active periods across controls, and iRBD, to clinically diagnosed α-synucleinopathies. In study 2, higher levels (all p values were adjusted by false discovery rate < 0.05) of baseline objective probable napping, activity fragmentation, and physical inactivity during active periods were associated with the conversion of patients with iRBD into clinically diagnosed α-synucleinopathies at 2 years of follow-up with medium to large effect sizes (Cohen's d: 0.56 to 0.80). These findings were further supported by functional linear modeling analyses. Interpretation: Rest-activity pattern alterations, mainly objective probable napping behaviors, activity fragmentation, and physical inactivity during active period, emerge as early as at the stage of iRBD, which serves as early and robust prodromal markers of the conversion of iRBD into clinically diagnosed α-synucleinopathies.

show abstract

“…The details about the vPSG assessment and the method of scoring the EMG activity level during REM sleep were previously reported 13,20,21 . Briefly, only chin EMG level was used to quantify the RSWA.…”

Section: Methodsmentioning

confidence: 99%

“…The details about the vPSG assessment and the method of scoring the EMG activity level during REM sleep were previously reported. 13,20,21 Briefly, only chin EMG level was used to quantify the RSWA. Tonic EMG activity was defined as an increase in amplitude at least twice the background muscle tone that lasted for at least 5 seconds.…”

Section: Vpsg Assessment and Electromyographic (Emg) Scoringmentioning

confidence: 99%

Residual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow‐up Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

A BS TRACT: Background: The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injurious symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear. Objective: The objective of this study was to determine the rate and correlates of RIS and its association with the risk of neurodegenerative diseases in patients with iRBD. Methods: This was a retrospective cohort study. RIS was defined by the RBD Questionnaire-Hong Kong (RBDQ-HK) as the presence of residual sleep-related injuries or potential injurious behaviors for at least once a month after at least 1 year of treatment. Results: A total of 15 out of 133 (11.3%) patients with iRBD (age at diagnosis = 66.5 AE 7.3 years, 77.4% male) had RIS after 2.7 years of treatment. Patients with RIS were younger at both onset and polysomnographyconfirmed diagnosis of iRBD (years, mean AE standard deviation, 56.3 AE 6.9 vs. 61.8 AE 7.6, P = 0.01; 61.2 AE 4.2 vs. 67.2 AE 7.4, P < 0.001, respectively), had more severe behavioral symptoms at diagnosis (both RBDQ-HK total score and behavioral subscore, P = 0.01), and used a higher maximum dose of clonazepam (mg; median [interquartile range], 1.5 [1.0] vs. 1.0 [1.0], P = 0.01). RIS was probably associated with a higher risk of developing dementia with Lewy bodies (adjusted hazard ratio [95% confidence interval], 5.47 [1.71-17.46], adjusted for onset age of RBD), but not Parkinsons's disease in the follow-up. Conclusion: RIS is not uncommon in patients with iRBD despite long-term medication treatment. An earlier onset and more severe clinical profile are associated with RIS. The prediction of RIS toward dementia with Lewy bodies but not PD suggests that RIS may probably help to identify the specific risk of different subtypes of α-synucleinopathy.

show abstract

A case–control–family study of idiopathic rapid eye movement sleep behavior disorder

Cited by 20 publications

References 50 publications

Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

Rest‐Activity Pattern Alterations in Idiopathic REM Sleep Behavior Disorder

Residual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow‐up Study

Contact Info

Product

Resources

About