Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder

Objective: Our aim is to define the extent of comorbidities in order to improve clinical care of patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) utilizing the REM Sleep Behavior Disorder Associations with Parkinson's Disease Study (RAPiDS) cohort. Methods: Consecutive...

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Main Authors: Daniel A. Barone, Fei Wang, Lisa Ravdin, Mary Vo, Andrea Lee, Harini Sarva, Natalie Hellmers, Ana C. Krieger, Claire Henchcliffe
Format: Article
Language:English
Published: Elsevier 2020-01-01
Series:Clinical Parkinsonism & Related Disorders
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590112520300128
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author Daniel A. Barone
Fei Wang
Lisa Ravdin
Mary Vo
Andrea Lee
Harini Sarva
Natalie Hellmers
Ana C. Krieger
Claire Henchcliffe
author_facet Daniel A. Barone
Fei Wang
Lisa Ravdin
Mary Vo
Andrea Lee
Harini Sarva
Natalie Hellmers
Ana C. Krieger
Claire Henchcliffe
author_sort Daniel A. Barone
collection DOAJ
description Objective: Our aim is to define the extent of comorbidities in order to improve clinical care of patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) utilizing the REM Sleep Behavior Disorder Associations with Parkinson's Disease Study (RAPiDS) cohort. Methods: Consecutive adult study participants with iRBD confirmed on polysomnogram (PSG) were prospectively recruited from the Weill Cornell Center for Sleep Medicine. Evaluations comprised multiple facets of sleep, neurological, autonomic, and psychiatric function. Results: Participants evaluated included 30 individuals with iRBD, with mean 1.5 ± 2.3 years from PSG to neuropsychiatric evaluation. Mean age was 59.5 ± 16.0 years at time of PSG, and 6/30 were women. Urinary difficulties were reported in 14/30 (47%): slight 7 (23%), mild 4 (13%), moderate 2 (7%), and severe 1 (3.0%). Ten out of 29 (34%) had abnormal Montreal Cognitive Assessment (MoCA) scores and the mean was 26.5 ± 3.2. The distribution of MoCA scores was significantly associated with urinary problems insofar as the more severe urinary problems were, the lower the MoCA scores (p = 0.04). Conclusions: In this RAPiDS cohort, we detected an unexpectedly high occurrence of non-motor dysfunction. Our results point to the need for screening patients with iRBD for complaints that are actionable, for example those affecting mood, cognition, urinary function, and bowel function. We propose the term RBD+ to be used to identify such individuals. For the quality of life in patients diagnosed with RBD, a closer look by the clinician should be enacted, with appropriate referrals and workup.
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spelling doaj.art-4bff1d0e01b24a3aa968a7cf8d1ace5f2022-12-21T23:48:33ZengElsevierClinical Parkinsonism & Related Disorders2590-11252020-01-013100044Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorderDaniel A. Barone0Fei Wang1Lisa Ravdin2Mary Vo3Andrea Lee4Harini Sarva5Natalie Hellmers6Ana C. Krieger7Claire Henchcliffe8Corresponding author at: Weill Cornell Medical College, Center for Sleep Medicine, 425 East 61st 5th Floor, New York, NY 10065, United States of America.; Weill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaWeill Cornell Medical College, New York, NY, United States of AmericaObjective: Our aim is to define the extent of comorbidities in order to improve clinical care of patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) utilizing the REM Sleep Behavior Disorder Associations with Parkinson's Disease Study (RAPiDS) cohort. Methods: Consecutive adult study participants with iRBD confirmed on polysomnogram (PSG) were prospectively recruited from the Weill Cornell Center for Sleep Medicine. Evaluations comprised multiple facets of sleep, neurological, autonomic, and psychiatric function. Results: Participants evaluated included 30 individuals with iRBD, with mean 1.5 ± 2.3 years from PSG to neuropsychiatric evaluation. Mean age was 59.5 ± 16.0 years at time of PSG, and 6/30 were women. Urinary difficulties were reported in 14/30 (47%): slight 7 (23%), mild 4 (13%), moderate 2 (7%), and severe 1 (3.0%). Ten out of 29 (34%) had abnormal Montreal Cognitive Assessment (MoCA) scores and the mean was 26.5 ± 3.2. The distribution of MoCA scores was significantly associated with urinary problems insofar as the more severe urinary problems were, the lower the MoCA scores (p = 0.04). Conclusions: In this RAPiDS cohort, we detected an unexpectedly high occurrence of non-motor dysfunction. Our results point to the need for screening patients with iRBD for complaints that are actionable, for example those affecting mood, cognition, urinary function, and bowel function. We propose the term RBD+ to be used to identify such individuals. For the quality of life in patients diagnosed with RBD, a closer look by the clinician should be enacted, with appropriate referrals and workup.http://www.sciencedirect.com/science/article/pii/S2590112520300128RBDREM sleepAlpha-synucleinopathyParkinson's disease
spellingShingle Daniel A. Barone
Fei Wang
Lisa Ravdin
Mary Vo
Andrea Lee
Harini Sarva
Natalie Hellmers
Ana C. Krieger
Claire Henchcliffe
Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
Clinical Parkinsonism & Related Disorders
RBD
REM sleep
Alpha-synucleinopathy
Parkinson's disease
title Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
title_full Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
title_fullStr Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
title_full_unstemmed Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
title_short Comorbid neuropsychiatric and autonomic features in REM sleep behavior disorder
title_sort comorbid neuropsychiatric and autonomic features in rem sleep behavior disorder
topic RBD
REM sleep
Alpha-synucleinopathy
Parkinson's disease
url http://www.sciencedirect.com/science/article/pii/S2590112520300128
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