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Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study.
Mov Disord. 2012 May; 27(6):720-6.MD

Abstract

One of the most devastating nonmotor manifestations of PD is dementia. There are few established predictors of dementia in PD. In numerous cross-sectional studies, patients with rapid eye movement (REM) sleep behavior disorder (RBD) have increased cognitive impairment on neuropsychological testing, but no prospective studies have assessed whether RBD can predict Parkinson's dementia. PD patients who were free of dementia were enrolled in a prospective follow-up of a previously published cross-sectional study. All patients had a polysomnogram at baseline. Over a mean 4-year follow-up, the incidence of dementia was assessed in those with or without RBD at baseline using regression analysis, adjusting for age, sex, disease duration, and follow-up duration. Of 61 eligible patients, 45 (74%) were assessed and 42 were included in a full analysis. Twenty-seven patients had baseline RBD, and 15 did not. Four years after the initial evaluation, 48% with RBD developed dementia, compared to 0% of those without (P-adjusted = 0.014). All 13 patients who developed dementia had mild cognitive impairment on baseline examination. Baseline REM sleep atonia loss predicted development of dementia (% tonic REM = 73.2 ± 26.7 with dementia, 40.8 ± 34.5 without; P = 0.029). RBD at baseline also predicted the new development of hallucinations and cognitive fluctuations. In this prospective study, RBD was associated with increased risk of dementia. This indicates that RBD may be a marker of a relatively diffuse, complex subtype of PD.

Authors+Show Affiliations

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

22322798

Citation

Postuma, Ronald B., et al. "Rapid Eye Movement Sleep Behavior Disorder and Risk of Dementia in Parkinson's Disease: a Prospective Study." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 27, no. 6, 2012, pp. 720-6.
Postuma RB, Bertrand JA, Montplaisir J, et al. Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study. Mov Disord. 2012;27(6):720-6.
Postuma, R. B., Bertrand, J. A., Montplaisir, J., Desjardins, C., Vendette, M., Rios Romenets, S., Panisset, M., & Gagnon, J. F. (2012). Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study. Movement Disorders : Official Journal of the Movement Disorder Society, 27(6), 720-6. https://doi.org/10.1002/mds.24939
Postuma RB, et al. Rapid Eye Movement Sleep Behavior Disorder and Risk of Dementia in Parkinson's Disease: a Prospective Study. Mov Disord. 2012;27(6):720-6. PubMed PMID: 22322798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study. AU - Postuma,Ronald B, AU - Bertrand,Josie-Anne, AU - Montplaisir,Jacques, AU - Desjardins,Catherine, AU - Vendette,Mélanie, AU - Rios Romenets,Silvia, AU - Panisset,Michel, AU - Gagnon,Jean-François, Y1 - 2012/02/09/ PY - 2011/09/08/received PY - 2012/01/04/revised PY - 2012/01/06/accepted PY - 2012/2/11/entrez PY - 2012/2/11/pubmed PY - 2012/10/26/medline SP - 720 EP - 6 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 27 IS - 6 N2 - One of the most devastating nonmotor manifestations of PD is dementia. There are few established predictors of dementia in PD. In numerous cross-sectional studies, patients with rapid eye movement (REM) sleep behavior disorder (RBD) have increased cognitive impairment on neuropsychological testing, but no prospective studies have assessed whether RBD can predict Parkinson's dementia. PD patients who were free of dementia were enrolled in a prospective follow-up of a previously published cross-sectional study. All patients had a polysomnogram at baseline. Over a mean 4-year follow-up, the incidence of dementia was assessed in those with or without RBD at baseline using regression analysis, adjusting for age, sex, disease duration, and follow-up duration. Of 61 eligible patients, 45 (74%) were assessed and 42 were included in a full analysis. Twenty-seven patients had baseline RBD, and 15 did not. Four years after the initial evaluation, 48% with RBD developed dementia, compared to 0% of those without (P-adjusted = 0.014). All 13 patients who developed dementia had mild cognitive impairment on baseline examination. Baseline REM sleep atonia loss predicted development of dementia (% tonic REM = 73.2 ± 26.7 with dementia, 40.8 ± 34.5 without; P = 0.029). RBD at baseline also predicted the new development of hallucinations and cognitive fluctuations. In this prospective study, RBD was associated with increased risk of dementia. This indicates that RBD may be a marker of a relatively diffuse, complex subtype of PD. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/22322798/Rapid_eye_movement_sleep_behavior_disorder_and_risk_of_dementia_in_Parkinson's_disease:_a_prospective_study_ L2 - https://doi.org/10.1002/mds.24939 DB - PRIME DP - Unbound Medicine ER -