Probable RBD and association with neurodegenerative disease markers: A population‐based study

Mahlknecht, Philipp; Seppi, Klaus; Frauscher, Birgit; Kiechl, Stefan; Willeit, Johann; Stockner, Heike; Djamshidian, Atbin; Nocker, Michael; Rastner, Verena; Defrancesco, Michaela; Rungger, Gregor; Gasperi, Arno; Poewe, Werner; Högl, Birgit

doi:10.1002/mds.26350

Cited by 90 publications

(59 citation statements)

References 34 publications

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“…Our central finding is that the prevalence of PSG-confirmed RBD is 1.06% in those aged 40-80. This estimate is higher than previous studies which screened for sleep injury [25], considerably lower than questionnaire-based studies without PSG confirmation [26,27], and notably consistent with a smaller PSG-based study [28]. On analysis of risk factors, people with RBD use more antidepressants and antipsychotics and are more likely to have smoked.…”

Section: Discussionsupporting

confidence: 64%

“…Boot et al assessed 651 patients aged over 70 years with the Mayo Sleep Questionnaire and found possible RBD in 6.7% [26]. Mahlknecht et al assessed 456 participants aged over 60 years form the Bruneck cohort with the RBD Screening Questionnaire and the Innsbruck RBD-Inventory, and found a prevalence of RBD of 4.6% and 7.7%, respectively [27]. Wong et al found that 5.9% of men and 4.1% of women in a large Chinese general population aged over 24 years screened positive on the RBD single question screen [31].…”

Section: Prevalence Estimatesmentioning

confidence: 99%

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

Haba‐Rubio

Frauscher

Marques‐Vidal

et al. 2017

Sleep

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Study Objectives: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with neurodegenerative synucleinopathies. Its prevalence is largely unknown. This study determined the prevalence and characteristics of RBD in the general population using gold-standard polysomnography.Methods: Full polysomnographic data from 1,997 participants (age = 59 ± 11.1 years, 53.6% women) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Sleep-related complaints and habits were investigated using various sleep measures including the Munich Parasomnia Screening (MUPS) questionnaire, which includes two questions evaluating complex motor behaviors suggestive of RBD. Full polysomnography was performed at home. For participants screening positive for RBD, muscle activity during REM sleep was quantified to diagnose RBD.Results: Three hundred sixty-eight participants endorsed dream-enactment behavior on either of the two MUPS questions, and 21 fulfilled polysomnographic criteria for RBD, resulting in an estimated prevalence of 1.06% (95% CI = 0.61-1.50), with no difference between men and women. Compared with RBD− participants, RBD+ took more frequently antidepressants and antipsychotics (23.8% vs. 5.4%, p = .005; 14.3% vs. 1.5%, p = .004, respectively) and were more frequently smokers or exsmokers (85% vs. 56.6%, p = .011). On polysomnography, RBD+ had more stage N2 sleep (52 ± 11.5% vs. 46.3 ± 10.2%, p = .024) and less REM sleep (18 ± 6.4% vs. 21.9 ± 6.2%, p = .007), lower apnea-hypopnea index in REM sleep (3.8 ± 5.2 vs. 8.9 ± 13/hour, p = .035), and lower autonomic arousal index (31 ± 14.9 vs. 42.6 ± 19.5/hour, p = .002). Conclusions:In our middle-to-older age population-based sample, the prevalence of RBD was 1.06%, with no difference between men and women. RBD was associated with antidepressant and antipsychotic use and with minor differences in sleep structure.Key words: polysomnography; synucleinopathies; parasomnia; sleep; REM sleep without atonia Statement of SignificanceRapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia frequently associated or preceding neurodegenerative diseases such as synucleinopathies. Its occurrence in the general population is largely unknown. Analyzing data from 1,997 participants to the population-based HypnoLaus study who completed the Munich Parasomnia Screening questionnaire and had a complete polysomnography at home, we estimate the prevalence of RBD at 1.06%, with no significant difference between men and women. RBD was associated with antidepressant and antipsychotic use, and with minor differences in sleep structure. Knowing the prevalence and characteristics of RBD has important implications, as people with RBD can be ideal candidates for neuroprotective approaches, and can help us to better understand the progression of neurodegenerative disorders.

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Section: Discussionsupporting

confidence: 64%

Section: Prevalence Estimatesmentioning

confidence: 99%

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

Haba‐Rubio

Frauscher

Marques‐Vidal

et al. 2017

Sleep

Self Cite

206

131

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“…Patients with iRBD frequently reported NMS commonly found in advanced Parkinson's disease such as dribbling saliva, cognitive deficits, and hyposmia [42]. Moreover, the presence of RBD in the prodromal Parkinson's disease phase was associated with more cognitive deficits and with greater annual rate of cognitive decline, suggesting that RBD may be a risk factor for the development of dementia in Parkinson's disease [33 & ].…”

Section: Conversion To Synucleinopathymentioning

confidence: 99%

Sleep-wake disturbances in the premotor and early stage of Parkinson's disease

Bargiotas

Schuepbach

Bassetti

2016

Current Opinion in Neurology

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Purpose of reviewReview of recent literature pertaining to frequency, associations, mechanisms, and overall significance of sleep-wake disturbances (SWD) in the premotor and early phase of Parkinson's disease.Recent findings SWD are frequent in Parkinson's disease and their prevalence increases with disease progression. Recent studies confirm previous findings that SWD can appear as initial manifestation of Parkinson's disease even decades before motor signs appear and highlight their clinical associations in these early stages. More intriguingly, new evidence underpins their role as risk factors, predictors, or even as driving force for the neurodegenerative process. As our understanding of sleep-wake neurobiology increases, new hypotheses emerge concerning the pathophysiology of SWD in early Parkinson's disease stages involving dopaminergic and nondopaminergic mechanisms. INTRODUCTIONSleep-wake disturbances (SWD) are frequent in Parkinson's disease and are typically attributed to Parkinson's disease medications, poor sleep hygiene, and other nonmotor symptoms (NMS) such as nocturnal akinesia, pain, cramping, and nycturia. Over the past decade, notable advances have been made in the understanding of the role of the dopaminergic system in circadian mechanisms and sleep-wake physiology [1]. In addition, nondopaminergic systems are involved early in the pathogenesis of SWD in Parkinson's disease [2,3]. These findings suggest that SWD are no longer solely a complication of advanced PD but can emerge, among other NMS, in the premotor stages as a primary manifestation of neurodegeneration [4] and increase in frequency with Parkinson's disease progression (Fig. 1). Considering the importance of early diagnosis and intervention, the possibility that SWD may have prognostic value for the development of Parkinson's disease is intriguing.This review will discuss first the most recent literature on SWD in the context of premotor and early stage of Parkinson's disease and then important recent evidence on the pathophysiology of SWD in early Parkinson's disease. SUBJECTIVE SLEEP DISTURBANCES/ INSOMNIATwo thirds of patients with Parkinson's disease report poor sleep quality [5], many of them very early in the course of the disease [6,7]. Recent studies confirm the high prevalence of subjective sleep disturbances in the early stages of Parkinson's disease and highlight their association with low quality of life [8,9&& ,10 && ] and other NMS such as global cognitive impairment, anxiety, depression and nocturia [8]. Individuals later diagnosed with

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“…RBD [14,15] 1% The prevalence of RBD is about 0.5-1% in the general population and 2-8% in the older adult population More common (25-50%) in synucleinopathies (e.g. M. Parkinson) Sleep-related (nocturnal) eating disorders [16] …”

Section: Key Pointsmentioning

confidence: 99%

“…Neurodegeneration probable RBD is associated with neurodegenerative disease markers such as hyposmia and nonmotor symptoms [15] and over 50% of patients with idiopathic RBD develop within 5-10 years a neurodegenerative parkinsonian disorder (typically a synucleinopathy) [ [108]), RBD (limbic encephalitis, brainstem stroke, demyelinating disorders [109,110]), and RLS (e.g. spinal cord demyelination, subcortical stroke).…”

Section: Etiologymentioning

confidence: 99%

Sleep-related movement disorders and disturbances of motor control

Bargiotas

Bassetti²

2017

Current Opinion in Neurology

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Purpose of reviewReview of the literature pertaining to clinical presentation, classification, epidemiology, pathophysiology, diagnosis, and treatment of sleep-related movement disorders and disturbances of motor control. Recent findingsSleep-related movement disorders and disturbances of motor control are typically characterized by positive motor symptoms and are often associated with sleep disturbances and consequent daytime symptoms (e.g. fatigue, sleepiness). They often represent the first or main manifestation of underlying disorders of the central nervous system, which require specific work-up and treatment. Diverse and often combined cause factors have been identified. Although recent data provide some evidence regarding abnormal activation and/or disinhibition of motor circuits during sleep, for the majority of these disorders the pathogenetic mechanisms remain speculative. The differential diagnosis is sometimes difficult and misdiagnoses are not infrequent. The diagnosis is based on clinical and video-polysomnographic findings. Treatment of sleeprelated motor disturbances with few exceptions (e.g. restless legs/limbs syndrome) are based mainly on anecdotal reports or small series. SummaryMore state-of-the-art studies on the cause, pathophysiology, and treatment of sleep-related movement disorders and disturbances of motor control are needed.

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Probable RBD and association with neurodegenerative disease markers: A population‐based study

Abstract: Our findings may provide a basis for future studies intending to identify cohorts at risk for Lewy body diseases through screening of the general elderly population for RBD.

Cited by 90 publications

References 34 publications

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

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

Sleep-wake disturbances in the premotor and early stage of Parkinson's disease

Sleep-related movement disorders and disturbances of motor control

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