Clinical features and correlative factors of Parkinson’s disease patients with REM sleep behavior disorder / 中国神经精神疾病杂志

ABSTRACT

Objective To analyze the clinical features of rapid eye movement sleep behavior disorder (RBD) in pa?tients with Parkinson’s disease (PD) and investigate correlative factors of RBD. Methods Sixty-three consecutive PD pa?tients were included and classified into PD+RBD group (n=28) and PD-RBD group (n=35) according to REM Sleep Be?havior Disorder Questionnaire (RBDQ-HK). The degree of motor symptoms was compared using Unified Parkinson Dis?ease Rating Scale (UPDRS) and Hoehn&Yahr (H-Y) grade, the incidence of non motor symptoms was compared using non motor symptoms questionnaire (NMSquest), and the cognitive function, anxiety, depression, daytime sleep were com?pared using Montreal Cognitive Assessment (MOCA), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Epworth Sleep Scale (ESS) between the two groups. Results The incidence of RBD in PD patients was 44.4% (28/63). There were longer illness course ( χ2=12.733, P=0.002), older age (t=-2.292, P=0.025), and higher H-Y grades (χ2=7.014, P=0.008) in PD+RBD group, compared with those in PD-RBD group, but there were no significant differences in sex, onset age, onset form and levodapa dose equivalents (LDE) between the two groups. There were higher UPDRSⅡ,Ⅲ scores (t=-2.734, P=0.008; U=3.329, P=0.001) in PD+RBD group. Most of the non motor symptoms, including the gastrointestinal dysfunctions, psychiatric comorbidity and sleep disturbances were more frequent in PD+RBD group (P<0.05), and the incidence of anxiety and depression were higher (χ2=3.958, P=0.047; χ2=10.338, P=0.001), whereas there were no significant differences in cognitive function and daytime sleep between the two groups. In addition, constipation (OR=7.257), illness course (OR=5.389), UPDRS Ⅲ scores (OR=1.060) were correlative with RBD in PD patients. Con?clusion PD patients with longer illness course, older ages, and severe motor and non motor symptoms more likely suffer from RBD. Besides, constipation, long illness course and high UPDRSⅢscores may be risk factors of RBD.