Is REM sleep Behaviour Disorder (RBD) a risk factor of dementia in idiopathic Parkinson's disease?

Marion, Marie-Hélène; Qurashi, Maliha; Marshall, Geoff; Föster, O

doi:10.1007/s00415-008-0629-9

Cited by 119 publications

(76 citation statements)

References 30 publications

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“…Recent investigations detected a higher degree of cognitive dysfunction in PD populations with RBD, including executive deficits [36] visuo-spatial dysfunction, [26,38] and mild cognitive impairment [14]. Marion's' group found a higher risk for developing dementia in PD-RBD patients, although they could not find significant differences between RBD and non-RBD patients on any specific cognitive test [27].…”

Section: Introductionmentioning

confidence: 95%

Clinical features associated with REM sleep behavior disorder symptoms in the early stages of Parkinson’s disease

2010

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We aimed to characterize the clinical features associated with REM sleep behaviour disorder (RBD) in early stage Parkinson's disease (PD). Presence of clinical RBD was determined according to ICSD minimal clinical criteria and a validated RBD questionnaire. We registered time of appearance of RBD symptoms in relation to PD onset and the occurrence of RBD symptoms in the past in non-RBD patients. RBD and non-RBD groups were compared in terms of motor and cognitive dysfunction. The same comparisons were made between patients who reported RBD symptoms at some point in time (including those non-RBD patients that reported occurrence of RBD symptoms in the past) and those who did not (RBDS and non-RBDS, respectively). We assessed 75 patients. Forty-one (55%) patients presented with RBD, 19 beginning before PD onset. Five non-RBD patients reported having had RBD symptoms in the past. There were no significant differences between RBD and non-RBD patients. RBDS group presented a significantly higher proportion of non-tremor motor sub-type compared to non-RBDS patients. Our results suggest that RBD is very frequent in the early stages of PD. In some patients, RBD symptoms could have disappeared before or in the first years after motor disturbance onset. Non-tremor motor sub-type was related to RBD symptoms history, rather than to the presence of RBD clinical criteria at time of evaluation, suggesting that the physiopathological changes that cause the association with motor status could remain, in spite of symptom fluctuation.

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Section: Introductionmentioning

confidence: 95%

Clinical features associated with REM sleep behavior disorder symptoms in the early stages of Parkinson’s disease

2010

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“…However, their investigation was limited to non-demented subjects, which probably inadequately depicts the situation in routine care. Other studies have described non-motor symptoms and NPS in smaller, very specialized samples rather than from an epidemiological point of view [27,32]. Second, estimates of the occurrence risk of each of these complications vary widely, possibly due to assessment methods, designs, and samples.…”

Section: Introductionmentioning

confidence: 96%

Frequency of dementia, depression, and other neuropsychiatric symptoms in 1,449 outpatients with Parkinson’s disease

et al. 2010

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Neuropsychiatric symptoms (NPS) of Parkinson's disease (PD) are of growing diagnostic and therapeutic importance. Data on their prevalence and characteristics have been primarily derived from highly selective clinical populations. We have conducted a national study in the outpatient care sector to provide a fuller characterization of the frequency of dementia, depression, and other NPS in PD outpatients. We also examined associations with biosocial and neurological variables. A nationwide representative sample of 1,449 PD outpatients was examined with a standardized clinical interview. PD severity was rated with the Hoehn and Yahr (HY) scale and the Unified Parkinson's Disease Rating Scale. Depression was measured with the Montgomery-Asberg Depression Rating Scale. Cognitive impairment and dementia were assessed with the Mini-Mental State Exam and according to diagnostic criteria. Logistic regression analyses were used to investigate associations. At least one NPS occurred in 71% of all patients with PD. The estimated prevalences (ranges) by age group and HY-stage were: depression, 25% (13.2-47.9%), dementia, 29% (12.2-59.4%), and psychotic syndromes, 12.7% (3.1-40.9%). Other frequent complications were sleep disturbances (49%) and anxiety (20%). Depression was associated with gender but not with age. Dementia was associated with age. The rates and comorbidity of depression and dementia were driven by PD severity. NPS were highly prevalent in our comprehensive patient sample, largely representative of management problems occurring in an outpatient setting. PD outpatients are at an increased risk for all neuropsychiatric conditions, increasing with PD severity but not with age or age of onset (except dementia), revealing challenging symptom patterns.

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“…A longitudinal evaluation has indicated that the presence of RBD in PD could be a warning sign for the development of cognitive impairment [115]. Most of the studies showing that PD patients with RBD have more cognitive impairment are cross-sectional, which makes a cause-and-effect relationship difficult to establish [108,116,117]. Previously, visual hallucinations have been described as a common symptom in PD patients with RBD [115].…”

Section: Sleep Disordersmentioning

confidence: 99%

Sleep-Wake Disturbances in Parkinson’s Disease: Current Evidence regarding Diagnostic and Therapeutic Decisions

Bruin

Bittencourt²,

Tufik³

2012

Eur Neurol

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Sleep disorders have been frequently reported in patients with Parkinson’s disease (PD). However, there is insufficient evidence to guide precise recommendations on some diagnostic and treatment strategies. Here, we review clinical studies dealing with sleep abnormalities in PD and present clinical recommendations. Previous studies describing insomnia, excessive daytime sleepiness, narcolepsy-like episodes, circadian changes, sleep-disordered breathing, rapid eye movement sleep behavior disorder, vivid dreams and restless legs syndrome are evaluated. Longitudinal studies associating sleep disorders with PD onset or clinical deterioration are rare: only one longitudinal study associated daytime sleepiness with PD onset. Evidence suggests that clinical investigations must include direct questioning about depressive symptoms, nocturnal cramps, pain, nocturia and nighttime off periods. A patient interview must be conducted regarding sleep symptoms, including nightmares, abnormal behavior during sleep, snoring, restless legs syndrome and daytime sleepiness. Initial evidence indicates that light therapy improves motor function and depression. Advice on sleep hygiene, the treatment of concomitant depression and the careful use of dopaminergic drugs and hypnosedative agents should be considered. To date, very few controlled studies are available to make a recommendation for the management of sleep-wake disturbances in PD.

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Is REM sleep Behaviour Disorder (RBD) a risk factor of dementia in idiopathic Parkinson's disease?

Cited by 119 publications

References 30 publications

Clinical features associated with REM sleep behavior disorder symptoms in the early stages of Parkinson’s disease

Clinical features associated with REM sleep behavior disorder symptoms in the early stages of Parkinson’s disease

Frequency of dementia, depression, and other neuropsychiatric symptoms in 1,449 outpatients with Parkinson’s disease

Sleep-Wake Disturbances in Parkinson’s Disease: Current Evidence regarding Diagnostic and Therapeutic Decisions

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