REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features
Identifieur interne : 000E73 ( Main/Corpus ); précédent : 000E72; suivant : 000E74REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features
Auteurs : R B Postuma ; J F Gagnon ; M. Vendette ; K. Charland ; J. MontplaisirSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2008-10.
Abstract
Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease. Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age. Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p<0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p<0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups. Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.
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DOI: 10.1136/jnnp.2008.149195
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Vendette</name><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Charland, K" sort="Charland, K" uniqKey="Charland K" first="K" last="Charland">K. Charland</name><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Montplaisir, J" sort="Montplaisir, J" uniqKey="Montplaisir J" first="J" last="Montplaisir">J. Montplaisir</name><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:ED4FA367F0AE15B11653495E77865C1960AEFE81</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1136/jnnp.2008.149195</idno><idno type="url">https://api.istex.fr/document/ED4FA367F0AE15B11653495E77865C1960AEFE81/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000E73</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features</title><author><name sortKey="Postuma, R B" sort="Postuma, R B" uniqKey="Postuma R" first="R B" last="Postuma">R B Postuma</name><affiliation><mods:affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Gagnon, J F" sort="Gagnon, J F" uniqKey="Gagnon J" first="J F" last="Gagnon">J F Gagnon</name><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Vendette, M" sort="Vendette, M" uniqKey="Vendette M" first="M" last="Vendette">M. Vendette</name><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Charland, K" sort="Charland, K" uniqKey="Charland K" first="K" last="Charland">K. Charland</name><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Montplaisir, J" sort="Montplaisir, J" uniqKey="Montplaisir J" first="J" last="Montplaisir">J. Montplaisir</name><affiliation><mods:affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2008-10">2008-10</date><biblScope unit="volume">79</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1117">1117</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">ED4FA367F0AE15B11653495E77865C1960AEFE81</idno><idno type="DOI">10.1136/jnnp.2008.149195</idno><idno type="href">jnnp-79-1117.pdf</idno><idno type="ArticleID">jn149195</idno><idno type="PMID">18682443</idno><idno type="local">jnnp;79/10/1117</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease. Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age. Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p<0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p<0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups. Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>R B Postuma</name><affiliations><json:string>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</json:string><json:string>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>J F Gagnon</name><affiliations><json:string>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>M Vendette</name><affiliations><json:string>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>K Charland</name><affiliations><json:string>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</json:string></affiliations></json:item><json:item><name>J Montplaisir</name><affiliations><json:string>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Research papers</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Drugs: CNS (not psychiatric)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sleep disorders (neurology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Ophthalmology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Memory disorders (psychiatry)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sleep disorders</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease. Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age. Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p>0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p>0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups. Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.</abstract><qualityIndicators><score>7.275</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>7</keywordCount><abstractCharCount>1653</abstractCharCount><pdfWordCount>4323</pdfWordCount><pdfCharCount>28072</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>246</abstractWordCount></qualityIndicators><title>REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor 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Québec, Canada</affiliation></author><author><persName><forename type="first">M</forename><surname>Vendette</surname></persName><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation></author><author><persName><forename type="first">K</forename><surname>Charland</surname></persName><affiliation>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</affiliation></author><author><persName><forename type="first">J</forename><surname>Montplaisir</surname></persName><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2008-10"></date><biblScope unit="volume">79</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1117">1117</biblScope></imprint></monogr><idno type="istex">ED4FA367F0AE15B11653495E77865C1960AEFE81</idno><idno type="DOI">10.1136/jnnp.2008.149195</idno><idno type="href">jnnp-79-1117.pdf</idno><idno type="ArticleID">jn149195</idno><idno type="PMID">18682443</idno><idno type="local">jnnp;79/10/1117</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008-08-05</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease. Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age. Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p<0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p<0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups. Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Drugs: CNS (not psychiatric)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Sleep disorders (neurology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Ophthalmology</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Memory disorders (psychiatry)</term></item></list></keywords></textClass><textClass><keywords 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xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jn149195</article-id><article-id pub-id-type="doi">10.1136/jnnp.2008.149195</article-id><article-id pub-id-type="other">jnnp;79/10/1117</article-id><article-id pub-id-type="other">jnnp;jnnp.2008.149195</article-id><article-id pub-id-type="pmid">18682443</article-id><article-id pub-id-type="other">1117</article-id><article-id pub-id-type="other">jnnp.2008.149195</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Research papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: CNS (not psychiatric)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Parkinson's disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Sleep disorders (neurology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Ophthalmology</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Memory disorders (psychiatry)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Sleep disorders</subject></subj-group></article-categories><title-group><article-title>REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features</article-title><alt-title alt-title-type="running-head">Research paper</alt-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Postuma</surname><given-names>R B</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gagnon</surname><given-names>J F</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Vendette</surname><given-names>M</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Charland</surname><given-names>K</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Montplaisir</surname><given-names>J</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</addr-line> </aff><aff id="aff2"><label>2</label><addr-line>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</addr-line> </aff><aff id="aff3"><label>3</label><addr-line>Department of Psychiatry, Université de Montréal, Québec, Canada</addr-line> </aff><aff id="aff4"><label>4</label><addr-line>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</addr-line> </aff><author-notes><corresp>Dr R B Postuma, Department of Neurology, L7-305 Montreal General Hospital, 1650 Cedar Ave, Montreal, Quebec, Canada H3G 1A4; <email xlink:type="simple">ron.postuma@muhc.mcgill.ca</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2008</year></pub-date><pub-date pub-type="epub-original"><day>5</day><month>8</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>5</day><month>8</month><year>2008</year></pub-date><volume>79</volume><volume-id pub-id-type="other">79</volume-id><volume-id pub-id-type="other">79</volume-id><issue>10</issue><issue-id pub-id-type="other">jnnp;79/10</issue-id><issue-id pub-id-type="other">10</issue-id><issue-id pub-id-type="other">79/10</issue-id><fpage>1117</fpage><history><date date-type="received"><day>11</day><month>3</month><year>2008</year></date><date date-type="rev-recd"><day>18</day><month>4</month><year>2008</year></date><date date-type="accepted"><day>22</day><month>4</month><year>2008</year></date></history><permissions><copyright-statement>2008 BMJ Publishing Group</copyright-statement><copyright-year>2008</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-79-1117.pdf"></self-uri><abstract><sec><title>Background:</title><p>Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease.</p></sec><sec><title>Methods:</title><p>The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age.</p></sec><sec><title>Results:</title><p>Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p<0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p<0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups.</p></sec><sec><title>Conclusions:</title><p>The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features</title></titleInfo><name type="personal"><namePart type="given">R B</namePart><namePart type="family">Postuma</namePart><affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</affiliation><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J F</namePart><namePart type="family">Gagnon</namePart><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Vendette</namePart><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K</namePart><namePart type="family">Charland</namePart><affiliation>Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J</namePart><namePart type="family">Montplaisir</namePart><affiliation>Centre d’étude du sommeil, Hopital du Sacré-Coeur, Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Drugs: CNS (not psychiatric)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Parkinson's disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Sleep disorders (neurology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Ophthalmology</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Memory disorders (psychiatry)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Sleep disorders</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2008-10</dateIssued><dateCreated encoding="w3cdtf">2008-08-05</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson’s disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease. Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age. Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p<0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p<0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication (UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups. Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>79</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1117</start></extent></part></relatedItem><identifier type="istex">ED4FA367F0AE15B11653495E77865C1960AEFE81</identifier><identifier type="DOI">10.1136/jnnp.2008.149195</identifier><identifier type="href">jnnp-79-1117.pdf</identifier><identifier type="ArticleID">jn149195</identifier><identifier type="PMID">18682443</identifier><identifier type="local">jnnp;79/10/1117</identifier><accessCondition type="use and reproduction" contentType="copyright">2008 BMJ Publishing Group</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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