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Journal of Neurology

, Volume 259, Issue 8, pp 1606–1612 | Cite as

REM sleep behavior disorder in Japanese patients with Parkinson’s disease: a multicenter study using the REM sleep behavior disorder screening questionnaire

  • Yoshihiro Nihei
  • Kazushi Takahashi
  • Atsuo Koto
  • Ban Mihara
  • Yoko Morita
  • Kazuo Isozumi
  • Kouichi Ohta
  • Kazuhiro Muramatsu
  • Jun Gotoh
  • Keiji Yamaguchi
  • Yutaka Tomita
  • Hideki Sato
  • Morinobu Seki
  • Satoko Iwasawa
  • Norihiro Suzuki
Original Communication

Abstract

REM sleep behavior disorder (RBD) is known to be observed more frequently in patients with an α-synucleinopathy such as Parkinson’s disease (PD) than in the general population. The precise prevalence of RBD in Japanese PD patients is not known. Therefore, we investigated the prevalence and the clinical characteristics of patients with RBD in a large population of Japanese patients with PD. We investigated various clinical features and employed the Japanese version of the RBD screening questionnaire on 469 non-demented Japanese PD patients in this multicenter study. Probable or possible RBD was detected in 146 patients (31.1%) and was significantly associated with longer PD duration, higher Hoehn and Yahr stage, higher Unified Parkinson’s Disease Rating Scale part III subscale (7 items), more motor fluctuations, and a higher levodopa-equivalent daily dose (p < 0.01). As to the major autonomic dysfunctions, severe constipation was significantly more frequent in PD patients with RBD than in those without it (p < 0.01). The RBD symptoms of 53 patients (39.0%) preceded the onset of PD motor symptoms. The median interval from the onset of RBD symptoms to PD motor symptoms was 17.5 years, and 3 patients had intervals of over 50 years. This large-scale multicenter study revealed that RBD is a frequent non-motor symptom in Japanese patients with PD, which may precede the onset of motor symptoms. Moreover, RBD that increases with the duration and severity of PD may be associated with autonomic dysfunction.

Keywords

Parkinson’s disease Japanese patients REM sleep behavior disorder RBD screening questionnaire Premotor symptoms 

Notes

Conflicts of interest

None.

Supplementary material

415_2011_6386_MOESM1_ESM.pdf (85 kb)
Supplementary Table 1 (PDF 84 kb)

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Yoshihiro Nihei
    • 1
  • Kazushi Takahashi
    • 1
  • Atsuo Koto
    • 2
  • Ban Mihara
    • 3
  • Yoko Morita
    • 4
  • Kazuo Isozumi
    • 5
  • Kouichi Ohta
    • 6
  • Kazuhiro Muramatsu
    • 7
  • Jun Gotoh
    • 8
  • Keiji Yamaguchi
    • 9
  • Yutaka Tomita
    • 10
  • Hideki Sato
    • 11
  • Morinobu Seki
    • 1
  • Satoko Iwasawa
    • 12
  • Norihiro Suzuki
    • 1
  1. 1.Department of NeurologyKeio University School of MedicineTokyoJapan
  2. 2.Department of NeurologyYomiuri Land Keiyu HospitalTokyoJapan
  3. 3.Department of NeurologyMihara Memorial HospitalIsesakiJapan
  4. 4.Department of NeurologyNational Hospital Organization Tokyo Medical CenterTokyoJapan
  5. 5.Department of NeurologyAshikaga Red Cross HospitalAshikagaJapan
  6. 6.Department of NeurologyTachikawa HospitalTokyoJapan
  7. 7.Department of NeurologySaiseikai Yokohama-city Eastern HospitalYokohamaJapan
  8. 8.Department of NeurologySaiseikai Central HospitalTokyoJapan
  9. 9.Department of NeurologyMito Red Cross HospitalMitoJapan
  10. 10.Department of NeurologyTomita HospitalOkazakiJapan
  11. 11.Department of NeurologySaitama Municipal HospitalMidori-kuJapan
  12. 12.Department of Preventive Medicine and Public HealthKeio University School of MedicineTokyoJapan

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