Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study.
Identifieur interne : 000C44 ( Main/Exploration ); précédent : 000C43; suivant : 000C45Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study.
Auteurs : Ronald B. Postuma [Canada] ; Josie-Anne Bertrand ; Jacques Montplaisir ; Catherine Desjardins ; Mélanie Vendette ; Silvia Rios Romenets ; Michel Panisset ; Jean-François GagnonSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2012.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Cross-Sectional Studies, Dementia (complications), Dementia (diagnosis), Dementia (epidemiology), Female, Humans, Incidence, Male, Middle Aged, Neuropsychological Tests, Parkinson Disease (complications), Polysomnography, Prospective Studies, REM Sleep Behavior Disorder (complications), REM Sleep Behavior Disorder (diagnosis), REM Sleep Behavior Disorder (epidemiology), Risk.
- MESH :
- complications : Dementia, Parkinson Disease, REM Sleep Behavior Disorder.
- diagnosis : Dementia, REM Sleep Behavior Disorder.
- epidemiology : Dementia, REM Sleep Behavior Disorder.
- Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Incidence, Male, Middle Aged, Neuropsychological Tests, Polysomnography, Prospective Studies, Risk.
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.
DOI: 10.1002/mds.24939
PubMed: 22322798
Affiliations:
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Postuma</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Bertrand, Josie Anne" sort="Bertrand, Josie Anne" uniqKey="Bertrand J" first="Josie-Anne" last="Bertrand">Josie-Anne Bertrand</name></author><author><name sortKey="Montplaisir, Jacques" sort="Montplaisir, Jacques" uniqKey="Montplaisir J" first="Jacques" last="Montplaisir">Jacques Montplaisir</name></author><author><name sortKey="Desjardins, Catherine" sort="Desjardins, Catherine" uniqKey="Desjardins C" first="Catherine" last="Desjardins">Catherine Desjardins</name></author><author><name sortKey="Vendette, Melanie" sort="Vendette, Melanie" uniqKey="Vendette M" first="Mélanie" last="Vendette">Mélanie Vendette</name></author><author><name sortKey="Rios Romenets, Silvia" sort="Rios Romenets, Silvia" uniqKey="Rios Romenets S" first="Silvia" last="Rios Romenets">Silvia Rios Romenets</name></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name></author><author><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-François" last="Gagnon">Jean-François Gagnon</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="doi">10.1002/mds.24939</idno><idno type="RBID">pubmed:22322798</idno><idno type="pmid">22322798</idno><idno type="wicri:Area/PubMed/Corpus">000E64</idno><idno type="wicri:Area/PubMed/Curation">000E64</idno><idno type="wicri:Area/PubMed/Checkpoint">000C63</idno><idno type="wicri:Area/Ncbi/Merge">003566</idno><idno type="wicri:Area/Ncbi/Curation">003566</idno><idno type="wicri:Area/Ncbi/Checkpoint">003566</idno><idno type="wicri:Area/Main/Merge">000C54</idno><idno type="wicri:Area/Main/Curation">000C44</idno><idno type="wicri:Area/Main/Exploration">000C44</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study.</title><author><name sortKey="Postuma, Ronald B" sort="Postuma, Ronald B" uniqKey="Postuma R" first="Ronald B" last="Postuma">Ronald B. Postuma</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Bertrand, Josie Anne" sort="Bertrand, Josie Anne" uniqKey="Bertrand J" first="Josie-Anne" last="Bertrand">Josie-Anne Bertrand</name></author><author><name sortKey="Montplaisir, Jacques" sort="Montplaisir, Jacques" uniqKey="Montplaisir J" first="Jacques" last="Montplaisir">Jacques Montplaisir</name></author><author><name sortKey="Desjardins, Catherine" sort="Desjardins, Catherine" uniqKey="Desjardins C" first="Catherine" last="Desjardins">Catherine Desjardins</name></author><author><name sortKey="Vendette, Melanie" sort="Vendette, Melanie" uniqKey="Vendette M" first="Mélanie" last="Vendette">Mélanie Vendette</name></author><author><name sortKey="Rios Romenets, Silvia" sort="Rios Romenets, Silvia" uniqKey="Rios Romenets S" first="Silvia" last="Rios Romenets">Silvia Rios Romenets</name></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name></author><author><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-François" last="Gagnon">Jean-François Gagnon</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Dementia (complications)</term><term>Dementia (diagnosis)</term><term>Dementia (epidemiology)</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Parkinson Disease (complications)</term><term>Polysomnography</term><term>Prospective Studies</term><term>REM Sleep Behavior Disorder (complications)</term><term>REM Sleep Behavior Disorder (diagnosis)</term><term>REM Sleep Behavior Disorder (epidemiology)</term><term>Risk</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Dementia</term><term>Parkinson Disease</term><term>REM Sleep Behavior Disorder</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dementia</term><term>REM Sleep Behavior Disorder</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Dementia</term><term>REM Sleep Behavior Disorder</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Polysomnography</term><term>Prospective Studies</term><term>Risk</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Montréal</li></settlement><orgName><li>Université McGill</li></orgName></list><tree><noCountry><name sortKey="Bertrand, Josie Anne" sort="Bertrand, Josie Anne" uniqKey="Bertrand J" first="Josie-Anne" last="Bertrand">Josie-Anne Bertrand</name><name sortKey="Desjardins, Catherine" sort="Desjardins, Catherine" uniqKey="Desjardins C" first="Catherine" last="Desjardins">Catherine Desjardins</name><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-François" last="Gagnon">Jean-François Gagnon</name><name sortKey="Montplaisir, Jacques" sort="Montplaisir, Jacques" uniqKey="Montplaisir J" first="Jacques" last="Montplaisir">Jacques Montplaisir</name><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><name sortKey="Rios Romenets, Silvia" sort="Rios Romenets, Silvia" uniqKey="Rios Romenets S" first="Silvia" last="Rios Romenets">Silvia Rios Romenets</name><name sortKey="Vendette, Melanie" sort="Vendette, Melanie" uniqKey="Vendette M" first="Mélanie" last="Vendette">Mélanie Vendette</name></noCountry><country name="Canada"><region name="Québec"><name sortKey="Postuma, Ronald B" sort="Postuma, Ronald B" uniqKey="Postuma R" first="Ronald B" last="Postuma">Ronald B. 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