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Published on: September 22, 2020
Morbidities in rapid eye movement sleep behavior disorder.
Poul Jennum1, Geert Mayer, Yo-El Ju
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup, Copenhagen, Denmark. Poul.joergen.jennum@regionh.dk
Idiopathic REM sleep behavior disorder (iRBD) is linked to neurodegenerative diseases like Parkinson's and dementia with Lewy bodies. Early detection of iRBD may indicate a higher risk for these progressive neurological conditions.
Area of Science:
- Neurology
- Sleep Medicine
- Neurodegeneration
Background:
- Idiopathic REM sleep behavior disorder (iRBD) is frequently comorbid with neurological conditions.
- Synucleinopathies, particularly Parkinson disease (PD), are strongly associated with iRBD.
- iRBD is considered a significant risk factor for developing synucleinopathies.
Purpose of the Study:
- To explore the association between idiopathic REM sleep behavior disorder and various comorbid conditions.
- To highlight the role of iRBD as a potential pre-motor manifestation of synucleinopathies.
- To investigate the prognostic implications of iRBD in patients with neurodegenerative disorders.
Main Methods:
- Review of comorbidity studies on idiopathic REM sleep behavior disorder.
- Analysis of clinical and pathological data in patients with iRBD and neurodegenerative diseases.
- Examination of associations between iRBD and specific conditions like PD, dementia with Lewy bodies, and narcolepsy.
Main Results:
- iRBD is associated with cognitive impairment, olfactory dysfunction, autonomic dysfunction, and neuropsychiatric issues.
- Patients with PD and iRBD may experience poorer cognitive function and increased mortality.
- RBD in dementia strongly correlates with dementia with Lewy bodies hallmarks.
- RBD is also linked to narcolepsy, antidepressant use, autoimmune conditions, and brainstem lesions.
Conclusions:
- Idiopathic REM sleep behavior disorder is a significant harbinger of synucleinopathies and other neurological disorders.
- The presence of iRBD suggests a progressive neurodegenerative process.
- iRBD may represent a distinct subtype when associated with narcolepsy, warranting further investigation into its unique comorbidities.
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