REM sleep without atonia and nocturnal body position in prediagnostic Parkinson's disease

Dijkstra, Femke; Reyn, Nathan; Bruyn, Barbara de; Bossche, Karlien Van den; Volder, Ilse De; Willemen, Marc; Viaene, Mineke; Leenders, Jo; Cras, Patrick; Crosiers, David

doi:10.1016/j.sleep.2021.06.011

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Half of our participants with early‐stage PD had excessive muscle activity during REM sleep, but only a quarter met the full criteria for RBD (RWA plus violent movements/behaviors at home or on v‐PSG), hence a quarter had iRWA. This prevalence of RBD and RWA obtained in a systematic prospective and large series is consistent with previous studies in smaller groups with early‐stage PD 29,30 . RWA prevalence is higher (~60% of participants) in participants with more advanced PD, 11,31 and frequency increases over PD course 32 …”

Section: Discussionsupporting

confidence: 90%

“…This prevalence of RBD and RWA obtained in a systematic prospective and large series is consistent with previous studies in smaller groups with early-stage PD. 29,30 RWA prevalence is higher ($60% of participants) in participants with more advanced PD, 11,31 and frequency increases over PD course. 32 This study highlights the different clinical and prognostic values of iRWA versus RBD in early-stage PD.…”

Section: Discussionmentioning

confidence: 91%

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Isolated REM Sleep without Atonia Is Not Equivalent to REM Sleep Behavior Disorder in Early‐Stage Parkinson's Disease

Dodet,

Houot,

Leu‐Semenescu

et al. 2024

Movement Disorders

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BackgroundIn early‐stage Parkinson's disease (PD), rapid eye movement (REM) sleep behavior disorder (RBD) predicts poor cognitive and motor outcome. However, the baseline significance and disease evolution associated with isolated REM sleep without atonia (iRWA, ie, enhanced muscle tone during 8.7% of REM sleep, but no violent behavior) are not well understood.ObjectivesThe objective is to determine whether iRWA was a mild form of RBD and progressed similarly over time.MethodsParticipants with early PD (<4 years from medical diagnosis) were included from 2014 to 2021 in a longitudinal study. They underwent interviews and examinations in the motor, cognitive, autonomous, psychiatric, sensory, and sleep domains every year for 4 years along with a video polysomnography and magnetic resonance imaging examination of the locus coeruleus/subcoeruleus complex (LC/LsC) at baseline. The clinical characteristics were compared between groups with normal REM sleep, with iRWA and with RBD, at baseline and for 4 years.ResultsAmong 159 PD participants, 25% had RBD, 25% had iRWA, and 50% had normal REM sleep. At baseline, the non‐motor symptoms were less prevalent and the LC/LsC signal intensity was more intense in participants with iRWA than with RBD. Over 4 years, participants with normal REM sleep and with iRWA had a similar cognitive and motor trajectory, whereas participants with RBD had greater cognitive and motor decline.ConclusionsWe demonstrated that iRWA is frequent in early PD, but is not a milder form of RBD. Both groups have distinct baseline characteristics and clinical trajectories. They should be distinguished in clinical routine and research protocols. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 91%

Isolated REM Sleep without Atonia Is Not Equivalent to REM Sleep Behavior Disorder in Early‐Stage Parkinson's Disease

Dodet,

Houot,

Leu‐Semenescu

et al. 2024

Movement Disorders

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“…This finding is in line with an earlier study by Christensen et al with an unsupervised, data-driven machine learning approach that identified a decrease in NREM3 duration and the inability to maintain the NREM and REM phases as potential early predictors of PD [39]. Finally, before the onset of parkinsonism and irrespective of the presence of RBD [40].…”

Section: Computerized Algorithmssupporting

confidence: 91%

Rapid eye movement sleep behavior disorder: a narrative review from a technological perspective

Gnarra

Wulf

Schäfer

et al. 2023

Sleep

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Study objectives Isolated REM sleep behaviour disorder (iRBD) is a parasomnia characterized by dream enactment. It represents a prodromal state of alpha-synucleinopathies, like Parkinson’s disease. In recent years, biomarkers of increased risk of phenoconversion from iRBD to overt alpha-synucleinopathies have been identified. Currently, diagnosis and monitoring rely on subjective reports and polysomnography performed in the sleep lab, which is limited in availability and cost intensive. Wearable technologies and computerized algorithms may provide comfortable and cost-efficient means to not only improve the identification of iRBD patients but also to monitor risk factors of phenoconversion. In this work, we review studies using these technologies to identify iRBD or monitor phenoconversion biomarkers. Methods A review of articles published until 31st May 2022 using the Medline database was performed. We included only papers in which subjects with RBD were part of the study population. The selected papers were divided into four sessions: actigraphy, gait analysis systems, computerized algorithms, and novel technologies. Results 25 articles were included in the review. Actigraphy, wearable accelerometers, pressure mats, smartphones, tablets, and algorithms based on polysomnography signals were used to identify RBD and monitor the phenoconversion. Rest-activity patterns, core body temperature, gait, and sleep parameters were able to identify the different stages of the disease. Conclusions These tools may complement current diagnostic systems in the future, providing objective ambulatory data obtained comfortably and inexpensively. Consequently, screening for iRBD and follow-up will be more accessible for the concerned patient cohort.

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“…First, our study aimed to investigate subjective nocturnal immobility, in which nocturnal immobility was evaluated using the MDS-UPDRS-2 questionnaire. Although our results clearly show that a significant amount of patients are aware of this symptom in both groups, the frequency is lower than in studies that used objective measures such as sensors and polysomnographies [3,4]. Consequently, our results may be an underestimation of true nocturnal bed immobility in (prodromal) PD.…”

Section: Discussioncontrasting

confidence: 81%

“…In contrast, nocturnal impaired bed mobility (impaired turning ability and supine body position during sleep) is considered to be a symptom of advanced disease [2]. However, recent studies using wearables or polysomnographies already show disturbances of body position and turning speed/ability in early and prediagnostic PD compared to control subjects [3,4]. These results suggest that impaired bed mobility is a very early PD sign.…”

Section: Introductionmentioning

confidence: 99%

impaired bed mobility in prediagnostic and de novo Parkinson’s disease

Dijkstra

Volder

Viaene³

et al. 2022

Preprint

Self Cite

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Background Wearable technology research suggests that nocturnal movements are disturbed in early Parkinson's disease (PD). In this study, we investigate if patients also already experience impaired bed mobility before PD diagnosis. Furthermore, we explore its association with motor and nonmotor features and its value for phenoconversion and disease progression prediction. Methods PPMI data were downloaded for de novo PD subjects, subjects at-risk for developing a synucleinopathy (with isolated REM sleep behavior disorder, hyposmia or a pathogenic mutation) and controls. Impaired bed mobility was assessed with the MDS-UPDRS part 2 item 9. A frequency analysis was performed. Multivariable logistic regression analyses were used to investigate the association with other PD variables. Cox proportional-hazards models were used to test if difficulties with turning in bed could predict phenoconversion. Linear mixed models were used to evaluate if difficulties with turning in bed could predict disease progression. Results Of the at-risk subjects, 9.2-12.5% experienced difficulties with turning in bed vs. 25.0% of de novo PD subjects and 2.5% of controls. Impaired turning ability was associated with MDSUPDRS motorscore (axial signs in the at-risk group, bradykinesia in the de novo PD group) and SCOPA-AUT score (gastrointestinal symptoms). In addition, difficulties with turning in bed were a significant predictor for phenoconversion in the at-risk group and for development of motor complications in the de novo PD group. Conclusion Our findings suggest that difficulties with turning in bed can be helpful as clinical symptom for a prodromal PD screening and for motor complication prediction in early PD.

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REM sleep without atonia and nocturnal body position in prediagnostic Parkinson's disease

Cited by 7 publications

References 38 publications

Isolated REM Sleep without Atonia Is Not Equivalent to REM Sleep Behavior Disorder in Early‐Stage Parkinson's Disease

Isolated REM Sleep without Atonia Is Not Equivalent to REM Sleep Behavior Disorder in Early‐Stage Parkinson's Disease

Rapid eye movement sleep behavior disorder: a narrative review from a technological perspective

impaired bed mobility in prediagnostic and de novo Parkinson’s disease

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