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Incidence and Progression of Rapid Eye Movement Behavior Disorder in Early Parkinson's Disease
Author(s) -
Zimansky Larissa,
Muntean MariaLucia,
Leha Andreas,
Mollenhauer Brit,
Trenkwalder Claudia,
SixelDöring Friederike
Publication year - 2021
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.13168
Subject(s) - parkinson's disease , rem sleep behavior disorder , rapid eye movement sleep , psychology , dyskinesia , cohort , levodopa , polysomnography , prospective cohort study , disease , medicine , eye movement , pediatrics , psychiatry , neuroscience , electroencephalography
Background Rapid eye movement (REM) sleep behavior disorder (RBD) is associated with neurodegenerative diseases; however, few longitudinal studies assess the individual evolution of RBD and REM sleep without atonia (RWA) in Parkinson's disease (PD). Objectives We aimed to evaluate RBD and RWA changes over time as well as potentially influential factors. Methods RBD and RWA were analyzed using video‐supported polysomnography (vPSG) in initially de novo PD patients at baseline and every 2 years for a total of 6 years. The influence of time, age, sex, levodopa equivalent daily dose (LEDD), unified Parkinson's disease rating scale (UPDRS) sum scores, benzodiazepine intake, Mini‐Mental State Examination (MMSE) total scores, and dyskinesia on RWA were investigated using mixed‐effect models to account for intra‐individual correlations. Results After 6 years, vPSG data were available from 98 of the initial 159 de novo PD patients. RBD prevalence increased from 25% at baseline to 52%. Of the 31 PD patients with RBD and valid vPSGs at all time‐points, RWA increased from an average of 19% at baseline to 41% at 6‐year follow‐up modeled to grow by 29.7% every 2 years ( P < 0.001). Time was an independent factor ( P < 0.001) for RWA increase. Age was an independent factor influencing RWA increase ( P = 0.04). Sex, LEDD, UPDRS sum scores, benzodiazepines, MMSE total scores, and dyskinesia did not have any significant influence. Conclusions RBD and RWA increased significantly over time in PD; time and age were independent factors in a prospective cohort. RBD and RWA can be considered PD progression markers.