ABSTRACT
Objective To investigate clinical features of tremors in PD patients with rapid eye movement sleep behavior disorder (RBD) and their response to medication. Methods PD patients were divided into PD with clinically possible (cp) RBD (PD+cpRBD) and PD without cpRBD (PD-cpRBD) according to RBDSQ scale. Hoehn & Yahr (H-Y) grade ,UPDRS-Ⅲ scale and MDS-UPDRS tremor scale were used to evaluate the motor function of the patients and amplitude of rest, kinetic and postural tremors of the first affected limbs. The re-sults were compared between these two groups including the features of the general information and tremor as well as the maximal improvement rate of UPDRS-Ⅲ and MDS-UPDRS tremor scores to acute levodopa chal-lenge test. Results A total of 42 PD patients with tremors were enrolled in this study, including 19 patients in PD+cpRBD group and 23 patients in PD-cpRBD group. There was no significant difference in sex, age, age of onset, duration of disease, UPDRS-Ⅲ score and H-Y grade between two groups (P>0.05). The tremor scores of the "off" state were significantly higher in PD+cpRBD group than in PD-cpRBD group (t=2.379,P=0.022). Compared with PD-cpRBD group, the progression of tremor from one side to other side was faster(u=-2.133,P=0.033)and the amplitude scores of rest and kinetic tremors were higher in PD+cpRBD group (rest tremor :u=-2.956,P=0.003;kinetic tremor:u=-2.657,P=0.008). The maximal improvement rate of UPDRS-Ⅲ and tremor score was significantly higher in PD-cpRBD group than in PD+cpRBD group after taking levodopa/ benserazide (200/50 mg) (UPDRS-Ⅲ:u=-3.134,P=0.002;tremor score: t=-3.189,P=0.003). Conclusion The present study has demonstrated severe tremors especially rest and kinetic tremors and poor response to levodopa in PD patients with cpRBD.