Journal of Neurology

, Volume 259, Issue 6, pp 1056–1061 | Cite as

Investigation of autonomic function in idiopathic REM sleep behavior disorder

  • Birgit Frauscher
  • Takashi Nomura
  • Susanne Duerr
  • Laura Ehrmann
  • Viola Gschliesser
  • Gregor K. Wenning
  • Elisabeth Wolf
  • Yuichi Inoue
  • Birgit Högl
  • Werner Poewe
Original Communication


Idiopathic REM sleep behavior disorder (iRBD) has been suggested as an early “pre-motor” stage of Parkinson’s disease (PD) in a significant proportion of cases. We investigated autonomic function in 15 consecutive iRBD patients and compared these findings to PD patients and healthy controls. All participants underwent cardiovascular autonomic function testing, and were rated on the COMPASS scale. Symptomatic orthostatic hypotension was present in two iRBD patients, two PD patients and none of the healthy controls. In the tilt table examination, blood pressure changes were similar between iRBD patients and healthy controls. In the PD group, blood pressure drops were more pronounced. In the orthostatic standing test, iRBD patients had higher blood pressure changes than healthy controls. Highest drops were found in PD. Valsalva ratio was lower in iRBD and PD compared to healthy controls. Total COMPASS score was higher in iRBD compared to healthy controls. Highest scores were found in PD. These results support the presence of autonomic dysfunction in iRBD. On several measures, dysfunction was intermediate between healthy controls and PD consistent with the concept that iRBD can be manifestation of synuclein-associated neurodegenerative disorders. Follow-up studies are needed to determine whether iRBD patients with dysfunction on several autonomic domains are at particular risk for developing one of these diseases.


Risk marker REM sleep behavior disorder COMPASS Neurodegenerative disease Autonomic function 



Takashi Nomura was supported by a fellowship of the Japanese Society of Sleep Research.

Conflict of interest

The authors declare that they have no conflict of interest with the present study.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Birgit Frauscher
    • 1
  • Takashi Nomura
    • 2
  • Susanne Duerr
    • 1
  • Laura Ehrmann
    • 1
  • Viola Gschliesser
    • 1
  • Gregor K. Wenning
    • 1
  • Elisabeth Wolf
    • 1
  • Yuichi Inoue
    • 3
  • Birgit Högl
    • 1
  • Werner Poewe
    • 1
  1. 1.Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Division of Neurology, Department of Brain and Neurosciences, Faculty of MedicineTottori UniversityYonagoJapan
  3. 3.Japan Somnology Center, Neuropsychiatric Research InstituteTokyoJapan

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