Subtle gait changes in patients with REM Behavior Disorder
Identifieur interne : 000763 ( Main/Exploration ); précédent : 000762; suivant : 000764Subtle gait changes in patients with REM Behavior Disorder
Auteurs : Eric M. Mcdade ; Brendon P. Boot ; Teresa Jh Christianson ; V. Shane Pankratz ; Bradley F. Boeve ; Tanis J. Ferman ; Kevin Bieniek ; John H. Hollman ; Rosebud O. Roberts ; Michelle M. Mielke ; David S. Knopman ; Ronald C. PetersenSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2013.
English descriptors
- KwdEn :
- MESH :
- complications : REM Sleep Behavior Disorder.
- diagnosis : Gait Disorders, Neurologic.
- etiology : Gait Disorders, Neurologic.
- Aged, Aged, 80 and over, Female, Humans, Linear Models, Male, Psychiatric Status Rating Scales, Psychometrics, Severity of Illness Index.
Abstract
Many people with REM sleep behavior disorder have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. As gait disorders are common in the synucleinopathies, early abnormalities in gait in those with REM sleep behavior disorder could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment.
We identified 42 probable REM sleep behavior disorder subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence and stride dynamics with an automated gait analysis system.
Cases and controls were similar in age (79.9 ± 4.7 & 80.1 ± 4.7, p= 0.74), UPDRS score (3.3 ± 5.5 & 1.9 ± 4.1, p=0.21) and Mini-Mental State Examination scores (27.2 ± 1.9 & 27.7 ± 1.6, p=0.10). A diagnosis of probable REM sleep behavior disorder was associated with decreased velocity (−7.9 cm/sec, 95%CI −13.8 to −2.0, p<0.01), cadence (−4.4 steps/min, 95%CI −7.6 to −1.3, p<0.01), and significantly increased double limb support variability (30%, 95%CI 6 – 60, p=0.01), greater stride time variability (29%, 95%CI 2 – 63, p=0.03) and swing time variability (46%, 95%CI 15 – 84, p<0.01).
Probable REM sleep behavior disorder is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable REM sleep behavior disorder supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.
Url:
DOI: 10.1002/mds.25653
PubMed: 24130124
PubMed Central: 3952497
Affiliations:
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Le document en format XML
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Boeve</name></author><author><name sortKey="Ferman, Tanis J" sort="Ferman, Tanis J" uniqKey="Ferman T" first="Tanis J." last="Ferman">Tanis J. Ferman</name></author><author><name sortKey="Bieniek, Kevin" sort="Bieniek, Kevin" uniqKey="Bieniek K" first="Kevin" last="Bieniek">Kevin Bieniek</name></author><author><name sortKey="Hollman, John H" sort="Hollman, John H" uniqKey="Hollman J" first="John H" last="Hollman">John H. Hollman</name></author><author><name sortKey="Roberts, Rosebud O" sort="Roberts, Rosebud O" uniqKey="Roberts R" first="Rosebud O" last="Roberts">Rosebud O. Roberts</name></author><author><name sortKey="Mielke, Michelle M" sort="Mielke, Michelle M" uniqKey="Mielke M" first="Michelle M" last="Mielke">Michelle M. Mielke</name></author><author><name sortKey="Knopman, David S" sort="Knopman, David S" uniqKey="Knopman D" first="David S." last="Knopman">David S. Knopman</name></author><author><name sortKey="Petersen, Ronald C" sort="Petersen, Ronald C" uniqKey="Petersen R" first="Ronald C." last="Petersen">Ronald C. 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Mcdade</name></author><author><name sortKey="Boot, Brendon P" sort="Boot, Brendon P" uniqKey="Boot B" first="Brendon P." last="Boot">Brendon P. Boot</name></author><author><name sortKey="Christianson, Teresa Jh" sort="Christianson, Teresa Jh" uniqKey="Christianson T" first="Teresa Jh" last="Christianson">Teresa Jh Christianson</name></author><author><name sortKey="Pankratz, V Shane" sort="Pankratz, V Shane" uniqKey="Pankratz V" first="V. Shane" last="Pankratz">V. Shane Pankratz</name></author><author><name sortKey="Boeve, Bradley F" sort="Boeve, Bradley F" uniqKey="Boeve B" first="Bradley F" last="Boeve">Bradley F. Boeve</name></author><author><name sortKey="Ferman, Tanis J" sort="Ferman, Tanis J" uniqKey="Ferman T" first="Tanis J." last="Ferman">Tanis J. Ferman</name></author><author><name sortKey="Bieniek, Kevin" sort="Bieniek, Kevin" uniqKey="Bieniek K" first="Kevin" last="Bieniek">Kevin Bieniek</name></author><author><name sortKey="Hollman, John H" sort="Hollman, John H" uniqKey="Hollman J" first="John H" last="Hollman">John H. Hollman</name></author><author><name sortKey="Roberts, Rosebud O" sort="Roberts, Rosebud O" uniqKey="Roberts R" first="Rosebud O" last="Roberts">Rosebud O. Roberts</name></author><author><name sortKey="Mielke, Michelle M" sort="Mielke, Michelle M" uniqKey="Mielke M" first="Michelle M" last="Mielke">Michelle M. Mielke</name></author><author><name sortKey="Knopman, David S" sort="Knopman, David S" uniqKey="Knopman D" first="David S." last="Knopman">David S. Knopman</name></author><author><name sortKey="Petersen, Ronald C" sort="Petersen, Ronald C" uniqKey="Petersen R" first="Ronald C." last="Petersen">Ronald C. Petersen</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Gait Disorders, Neurologic (diagnosis)</term><term>Gait Disorders, Neurologic (etiology)</term><term>Humans</term><term>Linear Models</term><term>Male</term><term>Psychiatric Status Rating Scales</term><term>Psychometrics</term><term>REM Sleep Behavior Disorder (complications)</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>REM Sleep Behavior Disorder</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Linear Models</term><term>Male</term><term>Psychiatric Status Rating Scales</term><term>Psychometrics</term><term>Severity of Illness Index</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P5">Many people with REM sleep behavior disorder have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. As gait disorders are common in the synucleinopathies, early abnormalities in gait in those with REM sleep behavior disorder could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment.</p></sec><sec id="S2"><title>Methods</title><p id="P6">We identified 42 probable REM sleep behavior disorder subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence and stride dynamics with an automated gait analysis system.</p></sec><sec id="S3"><title>Results</title><p id="P7">Cases and controls were similar in age (79.9 ± 4.7 & 80.1 ± 4.7, p= 0.74), UPDRS score (3.3 ± 5.5 & 1.9 ± 4.1, p=0.21) and Mini-Mental State Examination scores (27.2 ± 1.9 & 27.7 ± 1.6, p=0.10). A diagnosis of probable REM sleep behavior disorder was associated with decreased velocity (−7.9 cm/sec, 95%CI −13.8 to −2.0, p<0.01), cadence (−4.4 steps/min, 95%CI −7.6 to −1.3, p<0.01), and significantly increased double limb support variability (30%, 95%CI 6 – 60, p=0.01), greater stride time variability (29%, 95%CI 2 – 63, p=0.03) and swing time variability (46%, 95%CI 15 – 84, p<0.01).</p></sec><sec id="S4"><title>Conclusions</title><p id="P8">Probable REM sleep behavior disorder is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable REM sleep behavior disorder supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Bieniek, Kevin" sort="Bieniek, Kevin" uniqKey="Bieniek K" first="Kevin" last="Bieniek">Kevin Bieniek</name><name sortKey="Boeve, Bradley F" sort="Boeve, Bradley F" uniqKey="Boeve B" first="Bradley F" last="Boeve">Bradley F. Boeve</name><name sortKey="Boot, Brendon P" sort="Boot, Brendon P" uniqKey="Boot B" first="Brendon P." last="Boot">Brendon P. Boot</name><name sortKey="Christianson, Teresa Jh" sort="Christianson, Teresa Jh" uniqKey="Christianson T" first="Teresa Jh" last="Christianson">Teresa Jh Christianson</name><name sortKey="Ferman, Tanis J" sort="Ferman, Tanis J" uniqKey="Ferman T" first="Tanis J." last="Ferman">Tanis J. Ferman</name><name sortKey="Hollman, John H" sort="Hollman, John H" uniqKey="Hollman J" first="John H" last="Hollman">John H. Hollman</name><name sortKey="Knopman, David S" sort="Knopman, David S" uniqKey="Knopman D" first="David S." last="Knopman">David S. Knopman</name><name sortKey="Mcdade, Eric M" sort="Mcdade, Eric M" uniqKey="Mcdade E" first="Eric M" last="Mcdade">Eric M. Mcdade</name><name sortKey="Mielke, Michelle M" sort="Mielke, Michelle M" uniqKey="Mielke M" first="Michelle M" last="Mielke">Michelle M. Mielke</name><name sortKey="Pankratz, V Shane" sort="Pankratz, V Shane" uniqKey="Pankratz V" first="V. Shane" last="Pankratz">V. Shane Pankratz</name><name sortKey="Petersen, Ronald C" sort="Petersen, Ronald C" uniqKey="Petersen R" first="Ronald C." last="Petersen">Ronald C. Petersen</name><name sortKey="Roberts, Rosebud O" sort="Roberts, Rosebud O" uniqKey="Roberts R" first="Rosebud O" last="Roberts">Rosebud O. Roberts</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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