Autonomic Symptoms and Their Associated Factors in Elderly Idiopathic REM Sleep Behavior Disorder Patients

ABSTRACT

OBJECTIVES: Idiopathic REM sleep behavior disorder (RBD) is by far the strongest clinical predictor of neurodegenerative disease available. Several potential early diagnostic markers of neurodegenerative disease including autonomic symptoms have been proposed, but they have generally not been tested in presymptomatic neurodegenerative disease. So the authors investigated autonomic symptoms and their associated factors in idiopathic RBD patients. METHODS: 52 idiopathic RBD patients and 52 controls participated in the study. Autonomic symptoms were evaluated by applying the unified multiple system atrophy rating scale (UMSARS) and measuring orthostatic systolic blood pressure drop. RESULTS: Idiopathic RBD patients showed significantly higher UMSARS subscale scores and sharper drop of orthostatic systolic blood pressure than controls. In multiple linear regression analysis, all autonomic symptoms and measured orthostatic systolic blood pressure drop were associated with RBD. In addition, orthostatic symptoms were associated with medication and age, urinary function was associated with benign prostatic hyperplasia, and measured orthostatic systolic blood pressure drop was associated with hypertension. CONCLUSION: In this study, idiopathic RBD patients showed more autonomic symptoms than controls. However, other autonomic symptoms-related factors also influenced some autonomic symptoms. Prospective studies should be performed to evaluate autonomic symptoms as a potential predictor of neurodegenerative diseases.