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. 2024 Nov;271(11):7272-7281.
doi: 10.1007/s00415-024-12708-3. Epub 2024 Sep 30.

The paradoxical impact of periodic limb movements on isolated REM sleep behavior disorder patients

Samantha Mombelli  1   2 , Francesca Casoni  3 , Giada D'Este  3   4 , Caterina Leitner  3   4 , Sara Marelli  3 , Marco Zucconi  3 , Claudio Liguori  5   6 , Luigi Ferini-Strambi  3   4 , Andrea Galbiati  7   8
Affiliations

The paradoxical impact of periodic limb movements on isolated REM sleep behavior disorder patients

Samantha Mombelli et al. J Neurol. 2024 Nov.

Abstract

Recently, the α-synuclein origin and connectome model described two types of Parkinson's disease: "brain-first" and "body-first" subtypes. We aimed to investigate the role of periodic limb movements during sleep (PLMS) in identifying these subtypes starting from a prodromal stage of α-synucleinopathies. 191 patients with isolated REM sleep behavior disorder (iRBD) underwent video-polysomnography (vPSG), questionnaires, clinical interview, and neuropsychological battery. Patients who presented PLMS index (PLMSi) > 15 were compared with patients presenting PLMSi ≤ 15 on clinical questionnaires, vPSG, and neuropsychological domains with age as a covariate. Correlations were performed between PLMSi and vPSG and neuropsychological domains in both groups of iRBD. 48.2% of patients presented PLMSi > 15. iRBD subgroup with PLMSi > 15 performed better than the iRBD subgroup with PLMSi ≤ 15 in the executive function domain. In patients with PLMSi > 15 negative correlations were observed between PLMSi and some neuropsychological domains (memory, language, and executive function). Moreover, this subgroup was older and their PLMSi was positively correlated with wake-after-sleep onset and inversely correlated with total sleep time and sleep efficiency, suggesting a detrimental effect of PLM on sleep also in this cohort. Patients with PLMSi > 15 are characterized by a more preserved cognitive status, despite a more disrupted sleep. PLMSi could be explored in longitudinal studies concerning the "brain-first" and "body-first" model.

Keywords: Isolated REM sleep behavior disorder; Periodic limb movements; Phenotypes; α-Synuclein origin and connectome model.

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Conflict of interest statement

Declarations Conflicts of interest This work had no financial support. None of the authors of this manuscript had conflicts of interest. Ethical approval All the participants provided written informed consent previously approved by the local ethical committee according to the “1964 Declaration of Helsinki”.

References

    1. Uchihara T, Giasson BI (2016) Propagation of alpha-synuclein pathology: hypotheses, discoveries, and yet unresolved questions from experimental and human brain studies. Acta Neuropathol. https://doi.org/10.1007/s00401-015-1485-1 - DOI - PubMed
    1. Borghammer P (2018) How does parkinson’s disease begin? Perspectives on neuroanatomical pathways, prions, and histology. Mov Disord. https://doi.org/10.1002/mds.27138 - DOI - PubMed
    1. Borghammer P (2021) The α-synuclein origin and connectome model (SOC Model) of parkinson’s disease: explaining motor asymmetry, non-motor phenotypes, and cognitive decline. J Parkinsons Dis. https://doi.org/10.3233/JPD-202481 - DOI - PubMed - PMC
    1. American Academy of Sleep Medicine (2014) ICSD-III: The International Classification of Sleep Disorders: Diagnostic And Coding Manual, 3rd edn. American Academy of Sleep Medicine, Darien, IL
    1. Shen Y, Yu WB, Shen B, Dong H, Zhao J, Tang YL, Fan Y, Yang YF, Sun YM, Luo SS, Chen C, Liu FT, Wu JJ, Xiao BG, Yu H, Koprich JB, Huang ZL, Wang J (2020) Propagated α-synucleinopathy recapitulates REM sleep behaviour disorder followed by parkinsonian phenotypes in mice. Brain. https://doi.org/10.1093/brain/awaa283 - DOI - PubMed - PMC

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