Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease
Background: The literature is conflicting on whether rapid eye movement sleep behavior disorder (RBD) is associated with more rapid progression of Parkinson disease (PD).Objective: We aimed to determine (1) how stable probable RBD (pRBD) is over time and (2) whether it predicts faster PD progression...
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doaj-b24820cce75842edba68bba114b73a8b2021-04-07T05:24:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-04-011210.3389/fneur.2021.651157651157Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson DiseaseAshley Barasa0Jijia Wang1Richard B. Dewey2Department of Neurology, UT Southwestern Medical Center, Dallas, TX, United StatesDepartment of Applied Clinical Research, Southwestern School of Health Professions, UT Southwestern Medical Center, Dallas, TX, United StatesDepartment of Neurology, UT Southwestern Medical Center, Dallas, TX, United StatesBackground: The literature is conflicting on whether rapid eye movement sleep behavior disorder (RBD) is associated with more rapid progression of Parkinson disease (PD).Objective: We aimed to determine (1) how stable probable RBD (pRBD) is over time and (2) whether it predicts faster PD progression.Methods: We evaluated participants in the Parkinson's Disease Biomarker Project (PDBP) who were prospectively assessed every 6–12 months with a series of motor, non-motor, disability, and health status scales. For aim 1, we calculated the incidence and disappearance rates of pRBD and compared stability of pRBD in PD with control subjects. For aim 2, we developed multiple regression models to determine if pRBD at baseline influenced the rate of change or average value at 48 months of 10 outcome variables.Results: We found that pRBD was a less stable diagnosis for PD than controls. In pRBD+ subjects, the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score progressed 2.78 points per year faster (p < 0.01), MDS-UPDRS total score progressed 3.98 points per year faster (p < 0.01), a global composite outcome (GCO) worsened by 0.09 points per year faster (p = 0.02), and Parkinson's Disease Questionnaire (PDQ-39) mobility score progressed 2.57 percentage points per year faster (p < 0.01). The average scores at 48 months were 8.89 (p = 0.02) and 14.3 (p = 0.01) points higher for pRBD+ in MDS-UPDRS part III and total scores, respectively.Conclusions: Our study confirms that pRBD detected at the start of a study portends more rapid progression of PD. Knowing this could be useful for enriching clinical trials with fast progressors to accelerate discovery of a disease modifying agent.https://www.frontiersin.org/articles/10.3389/fneur.2021.651157/fullParkinson diseaseREM sleep behavior disorderprogressionseverityprediction |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ashley Barasa Jijia Wang Richard B. Dewey |
spellingShingle |
Ashley Barasa Jijia Wang Richard B. Dewey Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease Frontiers in Neurology Parkinson disease REM sleep behavior disorder progression severity prediction |
author_facet |
Ashley Barasa Jijia Wang Richard B. Dewey |
author_sort |
Ashley Barasa |
title |
Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease |
title_short |
Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease |
title_full |
Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease |
title_fullStr |
Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease |
title_full_unstemmed |
Probable REM Sleep Behavior Disorder Is a Risk Factor for Symptom Progression in Parkinson Disease |
title_sort |
probable rem sleep behavior disorder is a risk factor for symptom progression in parkinson disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-04-01 |
description |
Background: The literature is conflicting on whether rapid eye movement sleep behavior disorder (RBD) is associated with more rapid progression of Parkinson disease (PD).Objective: We aimed to determine (1) how stable probable RBD (pRBD) is over time and (2) whether it predicts faster PD progression.Methods: We evaluated participants in the Parkinson's Disease Biomarker Project (PDBP) who were prospectively assessed every 6–12 months with a series of motor, non-motor, disability, and health status scales. For aim 1, we calculated the incidence and disappearance rates of pRBD and compared stability of pRBD in PD with control subjects. For aim 2, we developed multiple regression models to determine if pRBD at baseline influenced the rate of change or average value at 48 months of 10 outcome variables.Results: We found that pRBD was a less stable diagnosis for PD than controls. In pRBD+ subjects, the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score progressed 2.78 points per year faster (p < 0.01), MDS-UPDRS total score progressed 3.98 points per year faster (p < 0.01), a global composite outcome (GCO) worsened by 0.09 points per year faster (p = 0.02), and Parkinson's Disease Questionnaire (PDQ-39) mobility score progressed 2.57 percentage points per year faster (p < 0.01). The average scores at 48 months were 8.89 (p = 0.02) and 14.3 (p = 0.01) points higher for pRBD+ in MDS-UPDRS part III and total scores, respectively.Conclusions: Our study confirms that pRBD detected at the start of a study portends more rapid progression of PD. Knowing this could be useful for enriching clinical trials with fast progressors to accelerate discovery of a disease modifying agent. |
topic |
Parkinson disease REM sleep behavior disorder progression severity prediction |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2021.651157/full |
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