Idiopathic REM sleep behavior disorder in the transition to degenerative disease.
Identifieur interne : 002827 ( Ncbi/Curation ); précédent : 002826; suivant : 002828Idiopathic REM sleep behavior disorder in the transition to degenerative disease.
Auteurs : Ronald B. Postuma [Canada] ; Jean-Francois Gagnon ; Melanie Vendette ; Jacques Y. MontplaisirSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Aged, Alzheimer Disease (diagnosis), Alzheimer Disease (etiology), Autonomic Nervous System (physiopathology), Cohort Studies, Depression (diagnosis), Depression (etiology), Disease Progression, Female, Humans, Lewy Body Disease (diagnosis), Lewy Body Disease (etiology), Male, Mental Status Schedule, Motor Activity (physiology), Neurodegenerative Diseases (diagnosis), Neurodegenerative Diseases (etiology), Neuropsychological Tests, Parkinson Disease (physiopathology), REM Sleep Behavior Disorder (complications), Retrospective Studies, Sensation Disorders (diagnosis), Sensation Disorders (etiology).
- MESH :
- complications : REM Sleep Behavior Disorder.
- diagnosis : Alzheimer Disease, Depression, Lewy Body Disease, Neurodegenerative Diseases, Sensation Disorders.
- etiology : Alzheimer Disease, Depression, Lewy Body Disease, Neurodegenerative Diseases, Sensation Disorders.
- physiology : Motor Activity.
- physiopathology : Autonomic Nervous System, Parkinson Disease.
- Aged, Cohort Studies, Disease Progression, Female, Humans, Male, Mental Status Schedule, Neuropsychological Tests, Retrospective Studies.
Abstract
Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability.
DOI: 10.1002/mds.22757
PubMed: 19768814
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pubmed:19768814Le document en format XML
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<author><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-Francois" last="Gagnon">Jean-Francois Gagnon</name>
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<author><name sortKey="Vendette, Melanie" sort="Vendette, Melanie" uniqKey="Vendette M" first="Melanie" last="Vendette">Melanie Vendette</name>
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<author><name sortKey="Montplaisir, Jacques Y" sort="Montplaisir, Jacques Y" uniqKey="Montplaisir J" first="Jacques Y" last="Montplaisir">Jacques Y. Montplaisir</name>
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<term>Depression (diagnosis)</term>
<term>Depression (etiology)</term>
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<term>Lewy Body Disease (diagnosis)</term>
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<term>Neurodegenerative Diseases (diagnosis)</term>
<term>Neurodegenerative Diseases (etiology)</term>
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<term>Sensation Disorders (etiology)</term>
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<term>Depression</term>
<term>Lewy Body Disease</term>
<term>Neurodegenerative Diseases</term>
<term>Sensation Disorders</term>
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<front><div type="abstract" xml:lang="en">Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability.</div>
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