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Multicenter Study
. 2015 May;77(5):830-9.
doi: 10.1002/ana.24385. Epub 2015 Mar 13.

Risk factors for neurodegeneration in idiopathic rapid eye movement sleep behavior disorder: a multicenter study

Ronald B Postuma  1 , Alex Iranzo, Birgit Hogl, Isabelle Arnulf, Luigi Ferini-Strambi, Raffaele Manni, Tomoyuki Miyamoto, Wolfgang Oertel, Yves Dauvilliers, Yo-El Ju, Monica Puligheddu, Karel Sonka, Amelie Pelletier, Juan Santamaria, Birgit Frauscher, Smaranda Leu-Semenescu, Marco Zucconi, Michele Terzaghi, Masayuki Miyamoto, Marcus M Unger, Bertrand Carlander, Maria-Livia Fantini, Jacques Y Montplaisir
Affiliations
Multicenter Study

Risk factors for neurodegeneration in idiopathic rapid eye movement sleep behavior disorder: a multicenter study

Ronald B Postuma et al. Ann Neurol. 2015 May.

Abstract

Objective: To assess whether risk factors for Parkinson disease and dementia with Lewy bodies increase rate of defined neurodegenerative disease in idiopathic rapid eye movement (REM) sleep behavior disorder (RBD).

Methods: Twelve centers administered a detailed questionnaire assessing risk factors for neurodegenerative synucleinopathy to patients with idiopathic RBD. Variables included demographics, lifestyle factors, pesticide exposures, occupation, comorbid conditions, medication use, family history, and autonomic/motor symptoms. After 4 years of follow-up, patients were assessed for dementia or parkinsonism. Disease risk was assessed with Kaplan-Meier analysis, and epidemiologic variables were compared between convertors and those still idiopathic using logistic regression.

Results: Of 305 patients, follow-up information was available for 279, of whom 93 (33.3%) developed defined neurodegenerative disease. Disease risk was 25% at 3 years and 41% after 5 years. Patients who converted were older (difference = 4.5 years, p < 0.001), with similar sex distribution. Neither caffeine, smoking, nor alcohol exposure predicted conversion. Although occupation was similar between groups, those who converted had a lower likelihood of pesticide exposure (occupational insecticide = 2.3% vs 9.0%). Convertors were more likely to report family history of dementia (odds ratio [OR] = 2.09), without significant differences in Parkinson disease or sleep disorders. Medication exposures and medical history were similar between groups. Autonomic and motor symptoms were more common among those who converted. Risk factors for primary dementia and parkinsonism were generally similar, except for a notably higher clonazepam use in dementia convertors (OR = 2.6).

Interpretation: Patients with idiopathic RBD are at very high risk of neurodegenerative synucleinopathy. Risk factor profiles between convertors and nonconvertors have both important commonalities and differences.

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Figures

Figure 1
Figure 1
Shown is a Kaplan-Meier analysis plotting disease-free survival (i.e. Parkinson’s disease, Dementia with Lewy Bodies and Multiple System Atrophy) in patients with Idiopathic REM sleep behavior disorder
See this image and copyright information in PMC

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References

    1. Schenck CH, Montplaisir JY, Frauscher B, Hogl B, Gagnon JF, Postuma R, et al. Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy-a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group. Sleep Med. 2013 - PMC - PubMed
    1. Schenck CH, Boeve BF, Mahowald MW. Delayed emergence of a parkinsonian disorder or dementia in 81% of older males initially diagnosed with idiopathic REM sleep behavior disorder (RBD): 16year update on a previously reported series. Sleep Med. 2013 - PubMed
    1. Iranzo A, Fernandez-Arcos A, Tolosa E, Serradell M, Molinuevo JL, Valldeoriola F, et al. Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients. PLoS One. 2014;9(2):e89741. - PMC - PubMed
    1. Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of Neurodegenerative Disease in Idiopathic REM sleep behavior disorder. Neurology. 2009;72(15):1296–300. - PMC - PubMed
    1. Wing YK, Li SX, Mok V, Lam SP, Tsoh J, Chan A, et al. Prospective outcome of rapid eye movement sleep behaviour disorder: psychiatric disorders as a potential early marker of Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2012;83(4):470–2. - PubMed

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