Autonomic dysfunction and phenoconversion in idiopathic REM sleep behavior disorder

被引:27
作者
McCarter, Stuart J. [1 ]
Gehrking, Tonette L. [1 ]
St Louis, Erik K. [1 ,2 ,3 ]
Suarez, Mariana D. [1 ]
Boeve, Bradley F. [1 ,3 ]
Silber, Michael H. [1 ,3 ]
Low, Phillip A. [1 ]
Singer, Wolfgang [1 ]
机构
[1] Mayo Clin, Dept Neurol, 200 First St Southwest, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Med, Rochester, MN USA
[3] Mayo Clin, Dept Sleep Med, Rochester, MN USA
基金
美国国家卫生研究院;
关键词
REM sleep behavior disorder (RBD); Autonomic; Phenoconversion; Parkinson's disease; Dementia with Lewy bodies; CONSENSUS STATEMENT; PARKINSONS-DISEASE; LEWY BODIES; DIAGNOSIS; DEMENTIA; SUDOMOTOR; FAILURE;
D O I
10.1007/s10286-020-00674-5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background REM sleep behavior disorder (RBD) is a common finding among patients with synucleinopathies. We aimed to determine the degree of autonomic dysfunction in patients presenting with idiopathic RBD (iRBD), and the predictive value of autonomic dysfunction for phenoconversion to a defined neurodegenerative disease. Methods We searched our electronic medical record for patients diagnosed with iRBD who also underwent standardized autonomic function testing within 6 months of iRBD diagnosis, and who had clinical follow-up of at least 3 years following iRBD diagnosis. The composite autonomic severity score (CASS) was derived and compared between phenoconverters and non-converters using chi-square and Wilcoxon rank-sum tests. Results We identified 18 patients who fulfilled inclusion and exclusion criteria. Average age at autonomic testing was 67 +/- 6.6 years. Twelve (67%) patients phenoconverted during the follow-up period; six developed Parkinson's disease (PD), and the other six, dementia with Lewy bodies (DLB). Fifteen (83%) patients had at least mild autonomic dysfunction. There were no significant differences between overall converters and non-converters in total CASS or CASS subscores. However, iRBD patients who developed DLB had significantly higher total and cardiovagal CASS scores compared with those who developed PD (p < 0.05), and a trend for higher adrenergic CASS scores compared to those who developed PD and those who did not phenoconvert. Discussion Autonomic dysfunction was seen in 83% of iRBD patients, and more severe baseline cardiovagal autonomic dysfunction in iRBD was associated with phenoconversion to DLB but not PD. Prospective studies are needed to confirm the value of autonomic testing for predicting phenoconversion and disease phenotype in iRBD.
引用
收藏
页码:207 / 213
页数:7
相关论文
共 23 条
[1]   Autonomic Sweat Responses in REM Sleep Behavior Disorder and Parkinsonism [J].
Al-Qassabi, Ahmed ;
Pelletier, Amelie ;
Fereshtehnejad, Seyed-Mohammad ;
Postuma, Ronald B. .
JOURNAL OF PARKINSONS DISEASE, 2018, 8 (03) :463-468
[2]   REM sleep behaviour disorder [J].
Dauvilliers, Yves ;
Schenck, Carlos H. ;
Postuma, Ronald B. ;
Iranzo, Alex ;
Luppi, Pierre-Herve ;
Plazzi, Giuseppe ;
Montplaisir, Jacques ;
Boeve, Bradley .
NATURE REVIEWS DISEASE PRIMERS, 2018, 4
[3]   Dermal phospho-alpha-synuclein deposits confirm REM sleep behaviour disorder as prodromal Parkinson's disease [J].
Doppler, Kathrin ;
Jentschke, Hanna-Maria ;
Schulmeyer, Lena ;
Vadasz, David ;
Janzen, Annette ;
Luster, Markus ;
Hoeffken, Helmut ;
Mayer, Geert ;
Brumberg, Joachim ;
Booij, Jan ;
Musacchio, Thomas ;
Klebe, Stephan ;
Sittig-Wiegand, Elisabeth ;
Volkmann, Jens ;
Sommer, Claudia ;
Oertel, Wolfgang H. .
ACTA NEUROPATHOLOGICA, 2017, 133 (04) :535-545
[4]   Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study [J].
Ferini-Strambi, Luigi ;
Oertel, Wolfgang ;
Dauvilliers, Yves ;
Postuma, Ronald B. ;
Marelli, Sara ;
Iranzo, Alex ;
Arnulf, Isabelle ;
Birgit, Hoegl ;
Manni, Raffaele ;
Miyamoto, Tomoyuki ;
Fantini, Maria-Livia ;
Puligheddu, Monica ;
Jennum, Poul ;
Sonka, Karel ;
Santamaria, Joan ;
Zucconi, Marco ;
Rancoita, Paola M. V. ;
Leu-Semenescu, Smeranda ;
Frauscher, Birgit ;
Terzaghi, Michele ;
Miyamoto, Masayuki ;
Unger, Marcus ;
Stiasny-Kolster, Karin ;
Desautels, Alex ;
Wolfson, Christina ;
Pelletier, Amelie ;
Montplaisir, Jacques .
JOURNAL OF NEUROLOGY, 2014, 261 (06) :1112-1118
[5]   Investigation of autonomic function in idiopathic REM sleep behavior disorder [J].
Frauscher, Birgit ;
Nomura, Takashi ;
Duerr, Susanne ;
Ehrmann, Laura ;
Gschliesser, Viola ;
Wenning, Gregor K. ;
Wolf, Elisabeth ;
Inoue, Yuichi ;
Hoegl, Birgit ;
Poewe, Werner .
JOURNAL OF NEUROLOGY, 2012, 259 (06) :1056-1061
[6]   Second consensus statement on the diagnosis of multiple system atrophy [J].
Gilman, S. ;
Wenning, G. K. ;
Low, P. A. ;
Brooks, D. J. ;
Mathias, C. J. ;
Trojanowski, J. Q. ;
Wood, N. W. ;
Colosimo, C. ;
Duerr, A. ;
Fowler, C. J. ;
Kaufmann, H. ;
Klockgether, T. ;
Lees, A. ;
Poewe, W. ;
Quinn, N. ;
Revesz, T. ;
Robertson, D. ;
Sandroni, P. ;
Seppi, K. ;
Vidailhet, M. .
NEUROLOGY, 2008, 71 (09) :670-676
[7]   ACCURACY OF CLINICAL-DIAGNOSIS OF IDIOPATHIC PARKINSONS-DISEASE - A CLINICOPATHOLOGICAL STUDY OF 100 CASES [J].
HUGHES, AJ ;
DANIEL, SE ;
KILFORD, L ;
LEES, AJ .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1992, 55 (03) :181-184
[8]   The Severity and Pattern of Autonomic Dysfunction in Idiopathic Rapid Eye Movement Sleep Behavior Disorder [J].
Lee, Hyung ;
Cho, Yong-Won ;
Kim, Hyun Ah .
MOVEMENT DISORDERS, 2015, 30 (13) :1843-1848
[9]  
Low PA, 1997, MUSCLE NERVE, V20, P1561, DOI 10.1002/(SICI)1097-4598(199712)20:12<1561::AID-MUS11>3.0.CO
[10]  
2-3