Dursun AYGÜN, Adem AKKURT, Musa Kazım ONAR, Yakup TÜRKEL

The effect of REM sleep behaviour disorder on clinical severity in Parkinson's disease

Aim: Differently from previous studies that directly compared Parkinson s disease (PD) patients with and without rapid eye movement (REM) sleep behavioural disorder (RBD) for the stage, severity, and duration of disease, this study investigated the relationship between the duration and clinical severity of disease in PD patients with and without RBD. Materials and methods: This retrospective study consisted of 141 PD patients older than 18 years of age. The clinical diagnosis of RBD was based on the minimal diagnostic criteria of the revised 2001 International Classification of Sleep Disorders. The patients were divided into 2 subgroups, those with and without clinical RBD. The groups were then compared with each other for sex, age, the duration of disease, and the Hoehn and Yahr stage and Unifi ed Parkinson s Disease Rating Scale scores. The correlation between the duration of disease and the clinical severity of PD was analysed in all patients. Results: There was no signifi cant difference between the groups in terms of sex, age, disease duration, and clinical severity scores. For the RBD patients there was a weak positive correlation between the duration of PD and clinical severity scores. However, there was no such correlation in the non-RBD (NRBD) subgroup. Conclusion: Our study indicates that in PD patients with RBD compared with NRBD patients, the time taken to reach the same clinical severity scores may be shorter.

PDF

___

1. Jankovic J. Parkinsons disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 2008; 79: 368-76.
2. Monderer R, Thorpy M. Sleep disorders and daytime sleepiness in Parkinsons disease. Curr Neurol Neuroscience Reports 2009; 9: 173-80.
3. Scaglione C, Vignatelli L, Plazzi G, Marchese R, Negrotti A, Rizzo G et al. REM sleep behaviour disorder in Parkinsons disease: a questionnaire-based study. Neurol Sci 2005; 25: 316-21.
4. Tachibana N. REM sleep behaviour disorder in Parkinsons disease. J Neurol 2007; 254 (Suppl 4): 8-14.
5. Lee JE, Kim KS, Shin H, Sohn YH. Factors related to clinically probable REM sleep behavior disorder in Parkinson disease. Parkinsonism Relat Disord 2010; 16: 105-8.
6. Postuma RB, Gagnon JF, Vandette M, Charland K, Montplaisir J. REM sleep behaviour disorder in Parkinsons disease is associated with specific motor features. J Neurol Neurosurg Psychiatry 2008; 79: 1117-21.
7. Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y et al. Clinical diagnostic criteria for dementia associated with Parkinsons disease. Mov Disord 2007; 22: 1689-707.
8. Gjerstad MD, Boeve B, Wentzel-Larsen T, Aarsland D, Larsen JP. Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinsons disease over time. J Neurol Neurosurg Psychiatry 2008; 79: 387-91.
9. Yoritaka A, Ohizumi H, Tanaka S, Hattori N. Parkinsons disease with and without REM sleep behaviour disorder: are there any clinical differences? Eur Neurol 2009; 61: 164-70.
10. American Academy of Sleep Medicine. International classifi cation of sleep disorders, revised (ICSD R): diagnostic and coding manual. Rochester (MN): Diagnostic Classifi cation Steering Committee, American Sleep Disorders Association; 2001.
11. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinsons disease: a clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55: 181-4.
12. Hanoglu L, Ozer F, Meral H, Dincer A. Brainstem 1H-MR spectroscopy in patients with Parkinsons disease with REM sleep behavior disorder and IPD patients without dream enactment behavior. J Clin Neurol Neurosurg 2006; 108: 129- 34.
13. Hawkes CH. The prodromal phase of sporadic Parkinsons disease: does it exist and if so how long is it? Mov Disord 2008; 23: 1799-807.
14. Hilker R, Schweitzer K, Coburger S, Ghaemi M, Weisenbach S, Jacobs AH et al. Progression of Parkinsons disease is non-linear as determined by serial PET imaging of striatal fl uorodopa F 18 activity. Arch Neurol 2005; 62: 378-82.
15. Lee MS, Rinne JO, Marsden CD. The pedunculopontine nucleus: its role in the genesis of movement disorders. Yonsei Med J 2000; 41: 167-84.
16. Olson EJ, Boeve BF, Silber MH. Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. Brain 2000; 123: 331-9.
17. Braak H, Del Tredici K, Rub U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinsons disease. Neurobiol Aging 2003; 24: 197-211.
18. Postuma RB, Lang AE, Massicotte-Marquez J, Montplaisir J. Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 2006; 66: 845-51.
19. Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology 2009; 72: 1296-300.