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Journal of Neurology

, Volume 261, Issue 6, pp 1112–1118 | Cite as

Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case–control study

  • Luigi Ferini-StrambiEmail author
  • Wolfgang Oertel
  • Yves Dauvilliers
  • Ronald B. Postuma
  • Sara Marelli
  • Alex Iranzo
  • Isabelle Arnulf
  • Högl Birgit
  • Raffaele Manni
  • Tomoyuki Miyamoto
  • Maria-Livia Fantini
  • Monica Puligheddu
  • Poul Jennum
  • Karel Sonka
  • Joan Santamaria
  • Marco Zucconi
  • Paola M. V. Rancoita
  • Smeranda Leu-Semenescu
  • Birgit Frauscher
  • Michele Terzaghi
  • Masayuki Miyamoto
  • Marcus Unger
  • Karin Stiasny-Kolster
  • Alex Desautels
  • Christina Wolfson
  • Amélie Pelletier
  • Jacques Montplaisir
Original Communication

Abstract

Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction. Our results show that compared to control subjects with a similar overall age and sex distribution, patients with iRBD experience significantly more problems with gastrointestinal, urinary, and cardiovascular functioning. The most prominent differences in severity of autonomic symptoms between our iRBD patients and controls emerged in the gastrointestinal domain. Interestingly, it has been reported that an altered gastrointestinal motility can predate the motor phase of PD. The cardiovascular domain SCOPA-AUT score in our study in iRBD patients was intermediate with respect to the scores reported in PD patients by other authors. Our findings underline the importance of collecting data on autonomic symptoms in iRBD. These data may be used in prospective studies for evaluating the risk of developing neurodegenerative disorders.

Keywords

REM sleep behavior disorder Autonomic function Parasomnia 

Notes

Conflicts of interest

The authors report no disclosures relevant to the manuscript. L. Ferini-Strambi has received honoraria for serving on scientific advisory boards from UCB, Mundipharma, Menarini. Full financial disclosure for the previous 12 months W. Oertel has received honoraria for consultancy and for serving on scientific advisory boards; travel support from UCB; and honoraria for consultancy and lecture fees from Teva, Novartis, GlaxoSmithKline, Boehringer Ingelheim, Orion Pharma, and Merck Serono. Y. Dauvilliers has received funds for speaking and board engagements with UCB, Cephalon, Jazz, and Bioprojet. R.B. Postuma has received research funds from the Canadian Institute of Health Research, Fonds de la Recherche en Sante Quebec, The Webster Foundation, and the Drummond Foundation, as well as funds for travel and speaker fees from Novartis Canada and Teva Neurosciences. A. Iranzo had speaking and board engagements with UCB and Sanofi-Synthelabo. I Arnulf received honoraria for a speaking engagement and board from UCB Pharma. I. Arnulf received honoraria from UCB Pharma and Jazz for a speaking engagement and consultancy. B. Hogl has received honoraria for speaking, serving on an advisory board, or consulting from UCB, Mundipharma, BI, GSK, Respironics, Sanofi, Lundbeck, and Jazz; and a grant to institution from UCB, and travel support from Habel Medizintechnik and Vivisol, Austria. K. Sonka served on a scientific advisory board for UCB Pharma, received lecture fees from Ipsen, Pfizer, UCB Pharma, and GlaxoSmithKline, and participated in clinical trials managed by UCB Pharma, Bioprojet, and Eisai; and received research support from Charles University in Prague (PRVOUK P26/LF1/4). B. Frauscher has had speaking engagements with UCB and received a competitive research grant from the Austrian Science Fund (KLI 236), grant of the Nationalbank of Austria (15127). M. Unger received grants from the Micheal J. Fox Foundation for Parkinson’s Research and from the International Parkinson Fonds Germany. K. Stiasny-Kolster has received honoraria for serving on the scientific advisory boards for Boehringer Ingelheim, and UCB, and has received honoraria for speaking engagements sponsored by UCB and Boehringer Ingelheim. J. Montplaisir received funds from Merck and GlaxoSmithKline, and has received honoraria for consultancy from Jazz, Merck, Valeant, Servier, and Impac laboratories. S. Marelli, R. Manni, T. Miyamoto, M.L. Fantini, M. Puligheddu, P. Jennum, J. Santamaria, M. Zucconi, M.V·P. Rancoita, S. Leu-Semenesceu, M. Terzaghi, M. Miyamoto, A. Desautels, C. Wolfson, and A. Pelletier have nothing to disclose.

Patient consent

Obtained.

Ethical standard

Each sleep center obtained approval from its local institutional review board.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Luigi Ferini-Strambi
    • 1
    Email author
  • Wolfgang Oertel
    • 2
  • Yves Dauvilliers
    • 3
  • Ronald B. Postuma
    • 4
  • Sara Marelli
    • 1
  • Alex Iranzo
    • 5
  • Isabelle Arnulf
    • 6
  • Högl Birgit
    • 7
  • Raffaele Manni
    • 8
  • Tomoyuki Miyamoto
    • 9
  • Maria-Livia Fantini
    • 10
  • Monica Puligheddu
    • 11
  • Poul Jennum
    • 12
  • Karel Sonka
    • 13
  • Joan Santamaria
    • 5
  • Marco Zucconi
    • 1
  • Paola M. V. Rancoita
    • 14
  • Smeranda Leu-Semenescu
    • 6
  • Birgit Frauscher
    • 7
  • Michele Terzaghi
    • 8
  • Masayuki Miyamoto
    • 9
  • Marcus Unger
    • 15
  • Karin Stiasny-Kolster
    • 2
  • Alex Desautels
    • 4
  • Christina Wolfson
    • 16
  • Amélie Pelletier
    • 4
  • Jacques Montplaisir
    • 4
  1. 1.Department of Clinical Neuroscience, Sleep Disorders CenterUniversità Vita-Salute San RaffaeleMilanItaly
  2. 2.Department of NeurologyPhilipps-University, MarburgMarburgGermany
  3. 3.Neurological DepartmentUniversity HospitalMontpellierFrance
  4. 4.Centre d’Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de MontréalMontrealCanada
  5. 5.Neurology ServiceHospital clinic de BarcelonaBarcelonaSpain
  6. 6.Unité des pathologies du sommeil, Hôpital Pitié-SalpêtrièreAPHP and Inserm U975-CRICM-Pierre and Marie Curie UniversityParis Cedex 13France
  7. 7.Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
  8. 8.Sleep and Epilepsy UnitIRCCS C. Mondino National Institute of Neurology FoundationPaviaItaly
  9. 9.Department of NeurologyDokkyo Medical University Koshigaya HospitalKoshigayaJapan
  10. 10.Department of Neurosciences, Sleep Disorders CenterUniversity of Turin, Ospedale San Giovanni Battista–MolinetteTurinItaly
  11. 11.Department of Cardiovascular and Neurological Sciences, Sleep CenterUniversity of CagliariCagliariItaly
  12. 12.Danish Center for Sleep MedicineUniversity of CopenhagenCopenhagenDenmark
  13. 13.Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in PragueCharles University in PraguePragueCzech Republic
  14. 14.CUSSB (University Centre for Statistics in the Biomedical Sciences), Vita-Salute San Raffaele UniversityMilanItaly
  15. 15.Department of NeurologySaarland University Homburg/SaarSaarGermany
  16. 16.Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealCanada

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