Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study

Clicks: 4
ID: 300890
2019
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #194 of 378 articles by views in Brain research

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 378 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Idiopathic REM sleep behaviour disorder (iRBD) is a powerful early sign of Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. This provides an unprecedented opportunity to directly observe prodromal neurodegenerative states, and potentially intervene with neuroprotective therapy. For future neuroprotective trials, it is essential to accurately estimate phenoconversion rate and identify potential predictors of phenoconversion. This study assessed the neurodegenerative disease risk and predictors of neurodegeneration in a large multicentre cohort of iRBD. We combined prospective follow-up data from 24 centres of the International RBD Study Group. At baseline, patients with polysomnographically-confirmed iRBD without parkinsonism or dementia underwent sleep, motor, cognitive, autonomic and special sensory testing. Patients were then prospectively followed, during which risk of dementia and parkinsonsim were assessed. The risk of dementia and parkinsonism was estimated with Kaplan-Meier analysis. Predictors of phenoconversion were assessed with Cox proportional hazards analysis, adjusting for age, sex, and centre. Sample size estimates for disease-modifying trials were calculated using a time-to-event analysis. Overall, 1280 patients were recruited. The average age was 66.3 ± 8.4 and 82.5% were male. Average follow-up was 4.6 years (range = 1-19 years). The overall conversion rate from iRBD to an overt neurodegenerative syndrome was 6.3% per year, with 73.5% converting after 12-year follow-up. The rate of phenoconversion was significantly increased with abnormal quantitative motor testing [hazard ratio (HR) = 3.16], objective motor examination (HR = 3.03), olfactory deficit (HR = 2.62), mild cognitive impairment (HR = 1.91-2.37), erectile dysfunction (HR = 2.13), motor symptoms (HR = 2.11), an abnormal DAT scan (HR = 1.98), colour vision abnormalities (HR = 1.69), constipation (HR = 1.67), REM atonia loss (HR = 1.54), and age (HR = 1.54). There was no significant predictive value of sex, daytime somnolence, insomnia, restless legs syndrome, sleep apnoea, urinary dysfunction, orthostatic symptoms, depression, anxiety, or hyperechogenicity on substantia nigra ultrasound. Among predictive markers, only cognitive variables were different at baseline between those converting to primary dementia versus parkinsonism. Sample size estimates for definitive neuroprotective trials ranged from 142 to 366 patients per arm. This large multicentre study documents the high phenoconversion rate from iRBD to an overt neurodegenerative syndrome. Our findings provide estimates of the relative predictive value of prodromal markers, which can be used to stratify patients for neuroprotective trials.
Reference Key
openalex_W2917107887 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ronald B. Postuma, Álex Iranzo, Joshua Shulman, Birgit Högl, Bradley F. Boeve, Raffaele Manni, Wolfgang H. Oertel, Isabelle Arnulf, Luigi Ferini‐Strambi, Monica Puligheddu, Elena Antelmi, Valérie Cochen De Cock, Dario Arnaldi, Brit Mollenhauer, Aleksandar Videnović, Karel Šonka, Ki‐Young Jung, Dieter Kunz, Yves Dauvilliers, Federica Provini, Simon J.G. Lewis, Jitka Bušková, Milena Pavlova, Anna Heidbreder, Jacques Montplaisir, Joan Santamaría, Thomas R. Barber, Ambra Stefani, Erik K. St. Louis, Michele Terzaghi, Annette Janzen, Smandra Leu-Semenescu, Giuseppe Plazzi, Flavio Nobili, F. Sixel-Doering, Petr Dušek, Frédérik Bes, Pietro Cortelli, Kaylena A. Ehgoetz Martens, Jean‐François Gagnon, Carles Gaig, Marco Zucconi, Claudia Trenkwalder, Ziv Gan‐Or, Christine Lo, Michal Rolinski, Philipp Mahlknecht, Evi Holzknecht, Angel R Boeve, Luke Teigen, Gianpaolo Toscano, Geert Mayer, Silvia Morbelli, Benjamin Dawson, Amélie Pelletier
Journal Brain research
Year 2019
DOI
10.1093/brain/awz030
URL
https://academic.oup.com/brain/article-pdf/142/3/744/27986652/awz030.pdf
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.