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Investigation of autonomic function in idiopathic REM sleep behavior disorder

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Abstract

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Birgit Frauscher, Susanne Duerr, Laura Ehrmann, Viola Gschliesser, Gregor K. Wenning, Elisabeth Wolf, Birgit Högl & Werner Poewe

  2. Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan

    Takashi Nomura

  3. Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan

    Yuichi Inoue

Authors
  1. Birgit Frauscher
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  2. Takashi Nomura
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  3. Susanne Duerr
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  4. Laura Ehrmann
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  5. Viola Gschliesser
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  6. Gregor K. Wenning
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  7. Elisabeth Wolf
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  8. Yuichi Inoue
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  9. Birgit Högl
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  10. Werner Poewe
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Corresponding author

Correspondence to Werner Poewe.

Additional information

B. Frauscher and T. Nomura contributed equally to this work.

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Frauscher, B., Nomura, T., Duerr, S. et al. Investigation of autonomic function in idiopathic REM sleep behavior disorder. J Neurol 259, 1056–1061 (2012). https://doi.org/10.1007/s00415-011-6298-0

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  • DOI: https://doi.org/10.1007/s00415-011-6298-0

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