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Meta-Analysis
. 2017 Jan 16:7:40779.
doi: 10.1038/srep40779.

Clinical variations in Parkinson's disease patients with or without REM sleep behaviour disorder: a meta-analysis

Ruo-Lin Zhu  1   2   3   1 , Cheng-Juan Xie  1   2   3   1 , Pan-Pan Hu  1   2   3   1 , Kai Wang  1   2   3   1
Affiliations
Meta-Analysis

Clinical variations in Parkinson's disease patients with or without REM sleep behaviour disorder: a meta-analysis

Ruo-Lin Zhu et al. Sci Rep. .

Abstract

This study aimed to evaluate the clinical variations in patients with Parkinson's disease (PD) with (PDRBD) or without REM sleep behaviour disorder (RBD) (Non-RBD), and PDRBD patients were classified into Confirmed-RBD (definite diagnosis with polysomnography, PSG) and Probable-RBD (without PSG re-confirmation). The clinical difference between the groups of patients was measured as an odds ratio (OR) or standardized mean difference (SMD, Cohen d). A total of 31 articles with data from 5,785 participants were obtained for our analysis. Overall, the occurrence of Confirmed-RBD was more frequent in male patients (OR = 1.25; p = 0.038), elderly patients (SMD = 0.25; p = 0.000), and patients with longer disease duration (SMD = 0.30; p = 0.000), increased Hoehn-Yahr scale (SMD = 0.30; p = 0.000), and higher UPDRS-III score (SMD = 0.38; p = 0.002). On the other hand, the frequency of Probable-RBD was increased with disease duration (SMD = 0.29; p = 0.000), Hoehn-Yahr scale (SMD = 0.30; p = 0.000), and UPDRS-III score (SMD = 0.26; p = 0.001). Our study indicate that PDRBD patients may have different clinical features compared to patients with Non-RBD.

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Figures

Figure 1
Figure 1. Study flow chart.
Figure 2
Figure 2. Forrest plot of the odds ratios (ORs) and standardised mean differences (SMD, Cohen d) for the clinical variations between PD patients with and without RBD (PDRBD and Non-RBD, respectively).
If the Cochran’s Q test had a p value < 0.05, the I2 over 75%, above 50% and below 25% were defined as high, moderate and low inconsistency, respectively. (A) Gender, (B) patient age, (C) onset age of Parkinson’s disease, (D) disease duration, (E) Hoehn-Yahr staging scale, and (F) Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) score.
Figure 3
Figure 3. Funnel plot with pseudo 95% confidence limits for assessment of publication bias.
(A) Gender, (B) patient age, (C) onset age of Parkinson’s disease, (D) disease duration, (E) Hoehn-Yahr staging scale, and (F) Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) score.
See this image and copyright information in PMC

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