B-29 REM Sleep Behavior Disorder in Non-Demented Parkinson’s Disease is Related to Poorer Cognitive Performance

Abstract

Abstract Objective Rapid eye movement sleep behavior disorder (RBD) affects 33-46% of patients with Parkinson’s Disease (PD) and may be a risk factor for neuropsychological impairment. However, the cognitive profile in PD patients with RBD has yet to be fully determined. This study examined differences in neuropsychological performance among non-demented PD patients with (PD/RBD+) and without RBD (PD/RBD-), and healthy controls (HC). Methods One hundred seventy-five participants, including 45 PD/RBD+ patients, 78 PD/RBD- patients, and 52 HC, completed the RBD sleep questionnaire and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function. Results The PD/RBD+ group demonstrated significantly poorer global neuropsychological performance compared to both the PD/RBD- and HC groups (p’s < .003; η_p^2 = .16). MANOVA demonstrated significant group differences on all individual cognitive domains (p’s < .001), except visuospatial function (p = .10). Both PD/RBD+ and PD/RBD- patients had significantly lower scores compared to the HCs in the domains of attention/working memory, language, learning, and memory. Additionally, the PD/RBD+ group had significantly lower executive functioning scores compared to the HCs, and poorer learning performance compared to the PD/RBD- group. Conclusions Compared to PD patients without RBD, PD/RBD+ patients have greater levels of cognitive impairment specific to the acquisition of new information. Moreover, PD/RBD+ patients have greater executive dysfunction compared to HCs, underscoring the importance of RBD assessment for improved detection and treatment of neuropsychological impairment (e.g., targeted cognitive interventions). Longitudinal investigations are needed to determine the enduring effects of RBD in PD.