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Idiopathic REM sleep behavior disorder in the transition to degenerative disease.
Mov Disord. 2009 Nov 15; 24(15):2225-32.MD

Abstract

Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability.

Authors+Show Affiliations

Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19768814

Citation

Postuma, Ronald B., et al. "Idiopathic REM Sleep Behavior Disorder in the Transition to Degenerative Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 24, no. 15, 2009, pp. 2225-32.
Postuma RB, Gagnon JF, Vendette M, et al. Idiopathic REM sleep behavior disorder in the transition to degenerative disease. Mov Disord. 2009;24(15):2225-32.
Postuma, R. B., Gagnon, J. F., Vendette, M., & Montplaisir, J. Y. (2009). Idiopathic REM sleep behavior disorder in the transition to degenerative disease. Movement Disorders : Official Journal of the Movement Disorder Society, 24(15), 2225-32. https://doi.org/10.1002/mds.22757
Postuma RB, et al. Idiopathic REM Sleep Behavior Disorder in the Transition to Degenerative Disease. Mov Disord. 2009 Nov 15;24(15):2225-32. PubMed PMID: 19768814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Idiopathic REM sleep behavior disorder in the transition to degenerative disease. AU - Postuma,Ronald B, AU - Gagnon,Jean-Francois, AU - Vendette,Melanie, AU - Montplaisir,Jacques Y, PY - 2009/9/22/entrez PY - 2009/9/22/pubmed PY - 2010/2/18/medline SP - 2225 EP - 32 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 24 IS - 15 N2 - Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/19768814/Idiopathic_REM_sleep_behavior_disorder_in_the_transition_to_degenerative_disease_ L2 - https://doi.org/10.1002/mds.22757 DB - PRIME DP - Unbound Medicine ER -