Timeline of Rapid Eye Movement Sleep Behavior Disorder in Overt Alpha‐Synucleinopathies

Objective The aim was to analyze the timeline, prevalence, and survival of rapid eye movement (REM) sleep behavior disorder (RBD) in patients who developed alpha‐synucleinopathies (Parkinson disease, dementia with Lewy bodies, and Parkinson disease dementia) compared with age‐ and sex‐matched contro...

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Bibliographic Details
Published in:Annals of neurology 2021-02, Vol.89 (2), p.293-303
Main Authors: Stang, Cole D., Mullan, Aidan F., Hajeb, Mania, Camerucci, Emanuele, Turcano, Pierpaolo, Martin, Peter, Mielke, Michelle M., Josephs, Keith A., Bower, James H., St Louis, Erik K., Boeve, Bradley F., Savica, Rodolfo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Behavior disorders
Case-Control Studies
Confidence intervals
Dementia
Dementia disorders
Disease Progression
Eye movements
Female
Humans
Incidence
Lewy bodies
Lewy Body Disease - epidemiology
Lewy Body Disease - physiopathology
Male
Medical records
Men
Mortality
Movement disorders
Neurodegenerative diseases
Parkinson Disease - epidemiology
Parkinson Disease - physiopathology
Parkinson's disease
Polysomnography
Population studies
Prevalence
REM sleep
REM Sleep Behavior Disorder - epidemiology
REM Sleep Behavior Disorder - physiopathology
Sex Distribution
Signs and symptoms
Sleep
Sleep disorders
Synucleinopathies - epidemiology
Synucleinopathies - physiopathology
Women
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Summary:Objective The aim was to analyze the timeline, prevalence, and survival of rapid eye movement (REM) sleep behavior disorder (RBD) in patients who developed alpha‐synucleinopathies (Parkinson disease, dementia with Lewy bodies, and Parkinson disease dementia) compared with age‐ and sex‐matched controls in a population‐based incident‐cohort study. Methods We used a population‐based, 1991 to 2010 incident‐cohort study of alpha‐synucleinopathies. A movement‐disorder specialist reviewed medical records to confirm diagnoses. RBD was diagnosed by reported dream‐enactment symptoms or polysomnography. Probable RBD and polysomnographically confirmed RBD were analyzed separately and combined. Results Among the 444 incident cases of alpha‐synucleinopathy, 86 were clinically diagnosed with RBD (19.8%), including 30 (35%) by polysomnography and 56 (65%) as probable. The prevalence of idiopathic RBD at alpha‐synucleinopathy diagnosis was 3.4%, increasing to 23.8% after 15 years. Cumulative lifetime incidence was 53 times greater in alpha‐synucleinopathy patients than in controls (odds ratio [OR] = 53.1, 95% confidence interval [CI]: 13.0–217.2, p 
ISSN:0364-5134
1531-8249
DOI:10.1002/ana.25952