Manifestations of Parkinson disease differ in association with REM sleep behavior disorder.
Identifieur interne : 002269 ( Ncbi/Curation ); précédent : 002268; suivant : 002270Manifestations of Parkinson disease differ in association with REM sleep behavior disorder.
Auteurs : Ronald B. Postuma [Canada] ; Jean-Francois Gagnon ; Melanie Vendette ; Katia Charland ; Jacques MontplaisirSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- Aged, Autonomic Nervous System Diseases (etiology), Electroencephalography, Female, Humans, Male, Middle Aged, Neurologic Examination, Olfaction Disorders (etiology), Parkinson Disease (complications), Parkinson Disease (psychology), Polysomnography, Quality of Life, REM Sleep Behavior Disorder (complications), REM Sleep Behavior Disorder (psychology), Severity of Illness Index.
- MESH :
- complications : Parkinson Disease, REM Sleep Behavior Disorder.
- etiology : Autonomic Nervous System Diseases, Olfaction Disorders.
- psychology : Parkinson Disease, REM Sleep Behavior Disorder.
- Aged, Electroencephalography, Female, Humans, Male, Middle Aged, Neurologic Examination, Polysomnography, Quality of Life, Severity of Illness Index.
Abstract
REM sleep behavior disorder (RBD) is commonly associated with Parkinson disease (PD), but it is unclear whether this association has implications for disease manifestations. We evaluated 36 PD patients for the presence of RBD by polysomnography. Patients underwent an extensive evaluation by a movement disorders specialist blinded to polysomnography results. Severity of motor manifestations, autonomic, visual, psychiatric, and olfactory dysfunctions and quality of life (QOL) were assessed, and compared using regression analysis that adjusted for disease duration, age and sex. Severity of motor manifestations did not differ between groups. However, the presence of RBD in PD was strongly associated with symptoms and signs of orthostatic hypotension (systolic blood pressure lying to standing = -25.7 +/- 13.0 mmHg vs. -4.9 +/-14.1, P < 0.001); and orthostatic symptom prevalence = 71% vs. 27%, P = 0.0076). There was no association between RBD and other autonomic symptoms. Color vision was worse in patients with RBD, but olfactory dysfunction did not differ between groups. The prevalence of depression, hallucinations, paranoia, and impulse disorders did not differ between groups. Emotional functioning and general health QOL measures were lower in those with RBD, but there were no differences between groups on disease-specific indices or on measures of overall physical QOL. These findings suggest that the pathophysiology of RBD and nonmotor manifestations of PD, particularly autonomic dysfunction, are linked.
DOI: 10.1002/mds.22099
PubMed: 18709686
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pubmed:18709686Le document en format XML
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<affiliation wicri:level="4"><nlm:affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada. ron.postuma@muhc.mcgill.ca</nlm:affiliation>
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<front><div type="abstract" xml:lang="en">REM sleep behavior disorder (RBD) is commonly associated with Parkinson disease (PD), but it is unclear whether this association has implications for disease manifestations. We evaluated 36 PD patients for the presence of RBD by polysomnography. Patients underwent an extensive evaluation by a movement disorders specialist blinded to polysomnography results. Severity of motor manifestations, autonomic, visual, psychiatric, and olfactory dysfunctions and quality of life (QOL) were assessed, and compared using regression analysis that adjusted for disease duration, age and sex. Severity of motor manifestations did not differ between groups. However, the presence of RBD in PD was strongly associated with symptoms and signs of orthostatic hypotension (systolic blood pressure lying to standing = -25.7 +/- 13.0 mmHg vs. -4.9 +/-14.1, P < 0.001); and orthostatic symptom prevalence = 71% vs. 27%, P = 0.0076). There was no association between RBD and other autonomic symptoms. Color vision was worse in patients with RBD, but olfactory dysfunction did not differ between groups. The prevalence of depression, hallucinations, paranoia, and impulse disorders did not differ between groups. Emotional functioning and general health QOL measures were lower in those with RBD, but there were no differences between groups on disease-specific indices or on measures of overall physical QOL. These findings suggest that the pathophysiology of RBD and nonmotor manifestations of PD, particularly autonomic dysfunction, are linked.</div>
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