Abstract
We aimed to characterize the clinical features associated with REM sleep behaviour disorder (RBD) in early stage Parkinson’s disease (PD). Presence of clinical RBD was determined according to ICSD minimal clinical criteria and a validated RBD questionnaire. We registered time of appearance of RBD symptoms in relation to PD onset and the occurrence of RBD symptoms in the past in non-RBD patients. RBD and non-RBD groups were compared in terms of motor and cognitive dysfunction. The same comparisons were made between patients who reported RBD symptoms at some point in time (including those non-RBD patients that reported occurrence of RBD symptoms in the past) and those who did not (RBDS and non-RBDS, respectively). We assessed 75 patients. Forty-one (55%) patients presented with RBD, 19 beginning before PD onset. Five non-RBD patients reported having had RBD symptoms in the past. There were no significant differences between RBD and non-RBD patients. RBDS group presented a significantly higher proportion of non-tremor motor sub-type compared to non-RBDS patients. Our results suggest that RBD is very frequent in the early stages of PD. In some patients, RBD symptoms could have disappeared before or in the first years after motor disturbance onset. Non-tremor motor sub-type was related to RBD symptoms history, rather than to the presence of RBD clinical criteria at time of evaluation, suggesting that the physiopathological changes that cause the association with motor status could remain, in spite of symptom fluctuation.
Similar content being viewed by others
References
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th edn. APA, Washington, DC
American Sleep Disorders Association (1997) International classification of sleep disorders, revised: diagnostic and coding manual. American Sleep Disorders Association, Rochester, MN
Boeve BF, Silber MH, Saper CB, Ferman TJ, Dickson DW, Parisi JE, Benarroch EE, Ahlskoh JE, Smith GE, Caselli RC, Tippman-Peikert M, Olson EJ, Lin SC, Young T, Wszolek Z, Schenck CH, Mahowald MW, Castillo PR, Del Tredici K, Braak H (2007) Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease. Brain 130(11):2770–2788
Boeve BF, Silber MH, Ferman TJ, Lucas JA, Parisi JE (2001) Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy. Mov Disord 16(4):622–630
Borek LL, Kohn R, Friedman JH (2007) Phenomenology of dreams in Parkinson’s disease. Mov Disord 22(2):198–202
Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211
Comella CL, Nardine TM, Diederich NJ, Stebbins GT (1998) Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology 51(2):526–529
De Cock VC, Vidailhet M, Leu S, Texeira A, Apartis E, Elbaz A, Roze E, Willer JC, Derenne JP, Agid Y, Arnulf I (2007) Restoration of normal muscle control in Parkinson’s disease during REM sleep. Brain 130:450–456
Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626
Eisensehr I, v Lindeiner H, Jäger M, Noachtar S (2001) REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson’s disease: is there a need for polysomnography? J Neurol Sci 186(1–2):7–11
Fahn S, Elton RL, members of the UPDRS development committee (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Calne DB, Lieberman A (eds) Recent developments in Parkinson’s disease. MacMillan Health Care Information, Florham Park, NJ, pp 153–163
Folstein M, Folstein S, McHugh P (1975) Mini-Mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Gagnon JF, Bédard MA, Fantini ML, Petit D, Panisset M, Rompré S, Carrier J, Montplaisir J (2002) REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology 59:585–589
Gagnon JF, Vendette M, Postuma RB, Desjardins C, Massicotte-Marquez J, Panisset M, Montplaisir J (2009) Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson’s disease. Ann Neurol 66:39–47
Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson’s disease. Arch Neurol 56:33–39
Gjerstrad MD, Boeve B, Wentzel-Larsen T, Aarsland D, Larsen JP (2008) Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson’s disease over time. J Neurol Neurosurg Psychiatry 79:387–391
Guerreiro M, Silva AP, Botelho MA (1994) Adaptação à população portuguesa da tradução do mini-mental state examination (MMSE). Revista Portuguesa de Neurologia 1:9
Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442
Iranzo A, Molinuevo JL, Santamaría J, Serradell M, Martí MJ, Valldeoriola F, Tolosa E (2006) Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: a descriptive study. Lancet Neurol 5:572–577
Jankovic J, McDermott M, Carter J, Gauthier S, Goetz C, Golbe L, Huber S, Koller W, Olanow C, Shoulson I, Stern M, Tanner C, Weiner W, Parkinson Study Group (1990) Variable expression of Parkinson’s disease: a base-line analysis of the DATATOP cohort. The Parkinson study group. Neurology 40(10):1529–1534
Kumru H, Santamaria J, Tolosa E, Iranzo A (2007) Relation between subtype of Parkinson’s disease and REM sleep behavior disorder. Sleep Med 8:779–783
Lavault S, Leu-Semenescu S, Tezenas du Montcel S, de Cock VC, Vidailhet M, Arnulf I. Does clinical rapid eye movement behavior disorder predict worse outcomes in Parkinson’s disease? J Neurol. doi:10.1007/s00415-010-5482-y
Lee JE, Kim KS, Shin H-W, Sohn YH (2010) Factors related to clinically probable REM sleep behaviour disorders in Parkinson disease. Parkinson Relat Disord 16(2):105–108
Levin BE, Katzen HL (1995) Early cognitive changes and nondementing behavioral abnormalities in Parkinson’s disease. Adv Neurol 65:85–95
Lima FC, Meireles LP, Fonseca R, Castro SL, Garrett C (2008) The frontal assessment battery (FAB) in Parkinson’s disease and correlations with formal measures of executive functioning. J Neurol 255(11):1756–1761
Marques A, Dujardin K, Boucart M, Pins D, Delliaux M, Defebvre L, Derambure F, Monaca C (2010) REM sleep behaviour disorder and visuoperceptive dysfunction:a disorder of the ventral visual stream? J Neurol. doi:10.1007/s00415-009-5328-7
Marion M, Qurashi M, Marshall G, Foster O (2008) Is REM sleep behaviour disorder (RBD) a risk factor of dementia in idiopathic Parkinson’s disease? J Neurol 255(2):192–196
Morgado J, Rocha CS, Maruta C, Guerreiro M, Martins IP (2009) Novos valores normativos do mini-mental state examination. Sinapse 9(2):10–16
Olson EJ, Boeve BF, Silber MH (2000) Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. Brain 123(2):331–339
Parkin SG, Gregory RP, Scott R, Bain P, Silburn P, Hall B, Boyle R, Joint C, Aziz TZ (2002) Unilateral and bilateral pallidotomy for idiopathic Parkinson’s disease: a case series of 115. Mov Disord 17:682–692
Póstuma RB, Gagnon JF, Vendette M, Charland K, Montplaisir J (2008) REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features. J Neurol Neurosurg Psychiatry 79:1117–1121
Póstuma RB, Gagnon J-F, Vendette M, Charland K, Montplaisir J (2008) Manifestations of Parkinson disease differ in association with REM sleep behavior disorder. Mov Disord 23(12):1665–1672
Scaglione C, Vignatelli L, Plazzi G, Marchese R, Negrotti A, Rizzo G, Lopane G, Bassein L, Maestri M, Bernardini S, Martinelli P, Abbruzzese G, Calzetti S, Bonuccelli U, Provini F, Coccagna G, Bologna, Genova, Parma and Pisa Universities Group for the study of REM Sleep Behavior Disorder in Parkinson’s Disease (2005) REM sleep behaviour disorder in Parkinson’s disease: a questionnaire-based study. Neurol Sci 25:316–321
Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW (1986) Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep 9:293–308
Schenck CH, Bundlie SR, Mahowald MW (1996) Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder. Neurology 46(2):388–393
Sinforiani E, Zangaglia R, Manni R, Cristina S, Marchioni E, Nappi G, Mancini F, Pacchetti C (2006) REM sleep behavior disorder, hallucinations, and cognitive impairment in Parkinson’s disease. Mov Disord 21(4):462–466
Stiasny-Kolster K, Mayer G, Schäfer S, Möller JC, Heinzel-Gutenbrunner M, Oertel WH (2007) The REM sleep behavior disorder screening questionnaire—a new diagnostic instrument. Mov Disord 22(16):2386–2393
Vendette M, Gagnon JF, Décary A, Massicotte-Marquez J, Postuma RB, Doyon J, Panisset M, Montplaisir J (2007) REM sleep behaviour disorder predicts cognitive impairment in Parkinson disease without dementia. Neurology 69(19):1843–1849
Yoritaka A, b Ohizumi H, Tanaka S, Hattori N (2009) Parkinson’s disease with and without. REM sleep behaviour disorder: are there any clinical differences? Eur Neurol 61:164–170
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bugalho, P., da Silva, J.A. & Neto, B. Clinical features associated with REM sleep behavior disorder symptoms in the early stages of Parkinson’s disease. J Neurol 258, 50–55 (2011). https://doi.org/10.1007/s00415-010-5679-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-010-5679-0