Skip to main content

Advertisement

SpringerLink
Log in

Is REM sleep Behaviour Disorder (RBD) a risk factor of dementia in idiopathic Parkinson's disease?

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Objective

To study the sequence of occurrence of REM-sleep behaviour disorder (RBD) and dementia and their frequency among a population of patients with idiopathic Parkinson's disease (PD).

Methods

We performed a cross-sectional study on 65 PD patients seen in a movement disorder clinic and their bed partner, and asked them to complete the validated Mayo Sleep Questionnaire for RBD and sleep disorders. The diagnosis of PD with dementia (PD-D) was based on a clinical diagnosis of dementia; following DSM-IV criteria and MMSE score less than 25 and a battery of cognitive tests.

Results

From the 65 patients that completed the study, twenty-four met the clinical diagnosis of RBD. Ten of the 24 (42%) RBD patients met the clinical criteria of PD-D, whereas the remaining 14 patients were non-demented at the time of the study. The frequency of RBD was significantly higher in the PD-D group (n = 10, 77%) compared to the PD-ND group (n = 14, 27%, chi squared test: p = 0.0008). PD non-RBD had a lower occurrence of dementia (7.3%, 3 of 41) compared to those suffering from RBD (42%, 10 of 24). Of the 65 PD patients, 13 were diagnosed with PD-D and the remaining 52 were non-demented PD (PD-ND) patients. PD with RBD showed a faster decline in the number of dementia-free patients compared to the non-RBD patients (Log Rank test: p < 0.001). RBD preceded, coincided or followed the onset of the motor symptoms.

Conclusion

This study shows that RBD and dementia have a significant coincidence in the course of PD, and RBD not only precedes or coincides with the motor signs, but can occur during the course of the progression of the PD, suggesting a degenerative process of the dopaminergic and cholinergic neurons of the brainstem nuclei, progressing at a different pace in each patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aarsland D, Mosimann P, Mc Keith IG (2004) Role of Cholinesterase inhibitors in Parkinson's disease and Dementia with Lewy bodies. J Geriatr Psychiatry Neurol 17:164–171

    Article  PubMed  Google Scholar 

  2. Aarsland D, Zaccai J, Brayne C (2005) A systematic review of prevalence studies of dementia in Parkinson's disease. Movement Disorders 20:1255–1263

    Article  PubMed  Google Scholar 

  3. American Sleep Disorders Association (1997) International Classification of Sleep Disorders, revised: diagnostic and coding manual. Rochester, MN: American Sleep Disorders Association, pp 177–180

  4. Arnulf I, Bonnet A, Damier P, et al. (2000) Hallucinations, REM sleep, and Parkinson's disease: A medical hypothesis. Neurology 55(2):281–288

    PubMed  CAS  Google Scholar 

  5. Boeve BF, Silber MH, Ferman TJ, et al. (1998) REM sleep Behavior disorder and degenerative dementia: An association likely reflecting Lewy body disease. Neurology 51(2):363–370

    PubMed  CAS  Google Scholar 

  6. Boeve BF, Silber MH, Ferman TJ, et al. (2001) Association of REM Sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy. Movement Disorders 16(4):622–630

    Article  PubMed  CAS  Google Scholar 

  7. Boeve BF, Silber MH, Ferman TJ, Smith GE (2002) Validation of a questionnaire for the diagnosis of REM sleep behavior disorder. Sleep 25(abstr Suppl.):A486

    Google Scholar 

  8. Boeve BF, Silber MH, Ferman TJ, Smith GE (2002) Validation of a questionnaire for the diagnosis of REM sleep behavior disorder. Neurology 58 (Suppl. 3):A509

    Google Scholar 

  9. Boeve BF, Silber MH, Parisi JE, et al. (2003) Synucleinopathy pathology and REM sleep behaviour disorder plus dementia or Parkinsonism. Neurology 61:40–45

    PubMed  CAS  Google Scholar 

  10. Bohnen NI, Kaufer DI, Ivanco LS, et al. (2003) Cortical cholinergic function is more severely affected in Parkinsonian dementia than in Alzheimer's disease. Arch Neurol 60:1745–1748

    Article  PubMed  Google Scholar 

  11. Braak H, Tredici KD, Rub U, et al. (2003) Staging of brain pathology related to sporadic Parkinson's disease. Neurobiology of Aging 24:197–211

    Article  PubMed  Google Scholar 

  12. Braak H, Rub U, Jansen Steur ENH, Del Tredici K, de Vos RAI (2005) Cognitive status correlates with neuropathologic stage in Parkinson disease. Neurology 64:1404–1410

    PubMed  CAS  Google Scholar 

  13. Burns A, Lawlor B, Craig S (1999) Assessment scales in old age psychiatry. Martin Dunitz Limited, London, p 45

  14. Dubois B, Pillon B, Lhermitte F, et al. (1990) Cholinergic deficiency and frontal dysfunction in Parkinson's disease. Ann Neurol 28:117–121

    Article  PubMed  CAS  Google Scholar 

  15. Emre M, et al. (2004) Rivastigmine for dementia associated with Parkinson's disease. N Engl J Med 351:2509–2518

    Article  PubMed  CAS  Google Scholar 

  16. Emre M (2004) Dementia in Parkinson's disease; cause and treatment. Current Opinion in Neurology 17(4):399–404

    Article  PubMed  Google Scholar 

  17. Ferman TJ, Boeve BF, Smith GE, et al. (1999) REM sleep behaviour disorder and dementia: Cognitive difference when compared with AD. Neurology 52(5):951–957

    PubMed  CAS  Google Scholar 

  18. Ferini-Strambi, Gioia D, Castronovo V, et al. (2004) Neuropsychological assessment in idiopathic REM sleep behaviour disorder (RBD). Does the idiopathic form of RBD really exist? Neurology 62:41–45

    PubMed  CAS  Google Scholar 

  19. Gagnon JF, Bedard MA, Fantini ML, et al. (2002) REM sleep behavior disorder and REM sleep without atonia in Parkinson's disease. Neurology 59(4):585–589

    PubMed  CAS  Google Scholar 

  20. Gagnon JF, Postuma RB, Mazza S, Doyon J, Montplaisir J (2006) Rapideye- movement sleep behaviour disorder and neurodegenerative diseases. Lancet Neurol 5:424–432

    Article  PubMed  Google Scholar 

  21. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. Journal of Neurology, Neurosurg, and Psychiatry 55:181–184

    Article  CAS  Google Scholar 

  22. Lai YY, Siegel JM (2003) Physiological and anatomical link between Parkinson- like disease and REM sleep behavior disorder. Molecular Neurobiology 27:137–151

    Article  PubMed  CAS  Google Scholar 

  23. McKeith, IG, Galasko D, Kosaka, K (1996) Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): Report of the consortium on DLB international workshop. Neurology 47(5):1113–1124

    PubMed  CAS  Google Scholar 

  24. Mosimann UP, Mather G, Wesnes KA, et al. (2004) Visual perception in Parkinson's disease dementia and dementia with Lewy bodies. Neurology 63(11):2091–2096

    PubMed  CAS  Google Scholar 

  25. Olson EJ, Boeve BF, Silber MH (2000) Rapid eye movement sleep behavior disorder: demographic, clinical and laboratory findings in 93 cases. Brain 123:331–339

    Article  PubMed  Google Scholar 

  26. 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

    PubMed  CAS  Google Scholar 

  27. Schenck CH, Bundlie SR, Mahowald MW (1996) Delayed emergence of a Parkinsonism disorder in 38% of 20 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder. Neurology 46:388–393

    PubMed  CAS  Google Scholar 

  28. Smith A (2002) Symbol digit modalities test manual. Western psychological services, Los Angeles

  29. Tiraboschi P, Hansen L, Alford M, et al. (2000) Cholinergic dysfunction in diseases with Lewy bodies. Neurology 54(2):407–417

    PubMed  CAS  Google Scholar 

  30. Tiraboschi P, Hansen L, Alford M, et al. (2002) Early and widespread cholinergic losses differentiate dementia with Lewy bodies from Alzheimer's disease. Arch Gen Psychiatry 59:946–951

    Article  PubMed  Google Scholar 

  31. Turner RS, D'Amato BS, Chervin RD, Blaivas M (2000) The pathology of REM sleep behavior disorder with comorbid Lewy body dementia. Neurology 55:1730–1732

    PubMed  CAS  Google Scholar 

  32. Van Gorp WG, Satz P, Mitrushima M (1990) Neuropsychological processes associated with normal aging. Developmental Neuropsychology 6(4):279–290

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Neurology, Atkinson Morley Wing, St George's Hospital, London, SW17 0Qt, UK

    M.-H. Marion, M. Qurashi & O. Foster

  2. Dept. of Neuropsychology, Atkinson Morley Wing, St George's Hospital, London

    G. Marshall

Authors
  1. M.-H. Marion
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Qurashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Marshall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. O. Foster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M.-H. Marion.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marion, MH., Qurashi, M., Marshall, G. et al. Is REM sleep Behaviour Disorder (RBD) a risk factor of dementia in idiopathic Parkinson's disease?. J Neurol 255, 192–196 (2008). https://doi.org/10.1007/s00415-008-0629-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-008-0629-9

Key words

Search

Navigation