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. 2014 May;85(5):560-6.
doi: 10.1136/jnnp-2013-306104. Epub 2013 Nov 1.

REM sleep behaviour disorder is associated with worse quality of life and other non-motor features in early Parkinson's disease

Michal Rolinski  1 , Konrad Szewczyk-Krolikowski, Paul R Tomlinson, Kannan Nithi, Kevin Talbot, Yoav Ben-Shlomo, Michele Tm Hu
Affiliations
Free PMC article

REM sleep behaviour disorder is associated with worse quality of life and other non-motor features in early Parkinson's disease

Michal Rolinski et al. J Neurol Neurosurg Psychiatry. 2014 May.
Free PMC article

Abstract

Background: Concomitant REM sleep behaviour disorder (RBD) is commonly observed in patients with Parkinson's disease (PD). Although the brainstem structures responsible for the symptoms of RBD correspond to the premotor stages of PD, the association of RBD with motor and non-motor features in early PD remains unclear.

Methods: The study evaluated 475 patients with PD within 3.5 years of diagnosis for the presence of probable RBD (pRBD) using the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ). A neurologist and a trained research nurse carried out evaluation of each participant blinded to the results of the RBDSQ. Standardised rating scales for motor and non-motor features of PD, as well as health-related quality of life measures, were assessed. Multiple linear and logistic regression analyses were used to determine the relationship between pRBD and a variety of outcomes, controlling for confounding factors.

Results: The overall frequency of pRBD was 47.2% (95% CI 42.7% to 51.9%). None of the patients had a previous diagnosis of RBD. Patients with PD and concomitant pRBD did not differ on motor phenotype and scored comparably on the objective motor scales, but reported problems with motor aspects of daily living more frequently. Adjusted for age, sex, disease duration and smoking history, pRBD was associated with greater sleepiness (p=0.001), depression (p=0.001) and cognitive impairment (p=0.006).

Conclusions: pRBD is common and under-recognised in early PD. It is associated with increased severity and frequency of non-motor features, poorer subjective motor performance and a greater impact on health-related quality of life.

Keywords: PARKINSON'S DISEASE; QUALITY OF LIFE; SLEEP DISORDERS.

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Figures

Figure 1
Figure 1
The frequency of clinically significant scores on disease severity scales. Sleepiness defined as Epworth Sleepiness Scale >9; Depression defined as Beck Depression Inventory >16; Cognitive impairments defined as MMSE score <26. *p=0.001, **p=0.006; all scores adjusted for age, sex, disease duration and smoking history.
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