Association of Concurrent Olfactory Dysfunction and Probable Rapid Eye Movement Sleep Behavior Disorder with Early Parkinson's Disease Progression

ABSTRACT Background Parkinson's disease (PD), with either rapid eye movement sleep behavior disorder (RBD) or olfactory dysfunction (OD), has been associated with disease progression. However, there is currently heterogeneity in predicting prognosis. Objectives To identify whether the concurren...

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Published in:Movement disorders clinical practice (Hoboken, N.J.) N.J.), 2022-10, Vol.9 (7), p.909-919
Main Authors: Chen, Ying, Xue, Nai‐Jia, Fang, Yi, Jin, Chong‐Yao, Li, Yao‐Lin, Tian, Jun, Yan, Ya‐Ping, Yin, Xin‐Zhen, Zhang, Bao‐Rong, Pu, Jia‐Li
Format: Article
Language:English
Subjects:
Behavior disorders
cognitive function
Eye movements
motor progression
Olfaction disorders
olfactory dysfunction
Parkinson's disease
REM sleep behavior disorder
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Summary:ABSTRACT Background Parkinson's disease (PD), with either rapid eye movement sleep behavior disorder (RBD) or olfactory dysfunction (OD), has been associated with disease progression. However, there is currently heterogeneity in predicting prognosis. Objectives To identify whether the concurrent presence of OD and probable RBD (pRBD) in PD (Dual hit in PD, PD‐DH) is associated with disease progression. Methods We included 420 patients with de novo PD from the Parkinson's Progression Markers Initiative: 180 PD only (PD), 82 PD with OD (PD‐OD), 94 PD with pRBD (PD‐pRBD), and 64 PD with both OD and pRBD (PD‐DH). Participants underwent motor and nonmotor evaluations, dopamine transporter imaging, and cerebrospinal fluid (CSF) assessment. Data were analyzed with generalized estimating equations and Cox proportional hazards analysis. Results The PD‐DH subtype was associated with higher scores and faster progression rates in Movement Disorder Society–Unified PD Rating Scale (MDS‐UPDRS) Parts II and III. Also, patients in PD‐DH group had faster deterioration in nonmotor symptoms, including MDS‐UPDRS Part I score, Montreal Cognitive Assessment, Hopkins Verbal Learning Test–Revised, Wechsler Memory Scale‐Third edition (WMS‐III) Letter Number Sequencing score, Symbol Digit Modalities Test, and Scales for Outcomes in PD–Autonomic scores, with all P values
ISSN:2330-1619
2330-1619
DOI:10.1002/mdc3.13511