Abstract

BackgroundRapid eye movement sleep behavior disorder (RBD) and Parkinson’s disease (PD) are two distinct clinical diseases but they share some common pathological and anatomical characteristics. This study aims to confirm the clinical features of RBD in Chinese PD patients.MethodsOne hundred fifty PD patients were enrolled from the Parkinson`s disease and Movement Disorders Center in Department of Neurology, Shanghai General Hospital from January 2013 to August 2014. This study examined PD patients with or without RBD as determined by the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), assessed motor subtype by Unified PD Rating Scale (UPDRS) III at “on” state, and compared the sub-scale scores representing tremor, rigidity, appendicular and axial. Investigators also assessed the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Parkinson’s disease Sleep Scale (PDSS).ResultsOne hundred fourty one PD patients entered the final study. 30 (21.28%) PD patients had probable RBD (pRBD) diagnosed with a RBDSQ score of 6 or above. There were no significant differences for age, including age of PD onset and PD duration, gender, smoking status, alcohol or coffee use, presence of anosmia or freezing, UPDRS III, and H-Y stages between the pRBD+ and pRBD− groups. pRBD+ group had lower MMSE scores, higher PDSS scores, and pRBD+ PD patients had more prominent proportion in anxiety, depression, constipation, hallucination and a greater prevalence of orthostatic hypotension.ConclusionpRBD+ PD patients exhibited greater changes in non-motor symptoms. However, there was no increase in motor deficits.

Highlights

  • Rapid eye movement sleep behavior disorder (RBD) and Parkinson’s disease (PD) are two distinct clinical diseases but they share some common pathological and anatomical characteristics

  • Nomura et al, determined that RBD rapid screening questionnaire (RBDSQ), which is completed by the patient, had a sensitivity of 84.2% and specificity of 96.2% to diagnose RBD when compared with standard RBD diagnostic criteria using PSG in PD at a cut off of 6 points [3]

  • We investigated the clinical features of PD patients with RBD in a tertiary referral center in China

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Summary

Introduction

Rapid eye movement sleep behavior disorder (RBD) and Parkinson’s disease (PD) are two distinct clinical diseases but they share some common pathological and anatomical characteristics. Nomura et al, determined that RBD rapid screening questionnaire (RBDSQ), which is completed by the patient, had a sensitivity of 84.2% and specificity of 96.2% to diagnose RBD when compared with standard RBD diagnostic criteria using PSG in PD at a cut off of 6 points (total score of RBDSQ is 13, and a score of 5 is the cut-off point for healthy individuals) [3]. Liu et al Translational Neurodegeneration (2017) 6:35 et al investigated the use of the RBDSQ plus Mayo Sleep questionnaire 1 (MSQ1) compared with PSG in PD patients. They found sensitivity was highest when the questionnaires were used in combination while specificity was highest for the RBDSQ used alone at a cut-off point of 7 [4]. Shen SS used the RBDSQ to diagnose RBD in Chinese patients, compared with PSG, and found a cutoff points at 6 had the best specificity and sensitivity [5]

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