Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study
Luigi Ferini-Strambi1, Wolfgang Oertel, Yves Dauvilliers
1Department of Clinical Neuroscience, Sleep Disorders Center, Università Vita-Salute San Raffaele, Via Stamira d' Ancona 20, 20127, Milan, Italy, ferinistrambi.luigi@hsr.it.
Journal of Neurology
|April 2, 2014
Summary
Patients with idiopathic REM sleep behavior disorder (iRBD) show significant gastrointestinal, urinary, and cardiovascular autonomic dysfunction. These findings highlight the need to monitor autonomic symptoms in iRBD for predicting neurodegenerative synucleinopathies.
Area of Science:
- Neurology
- Sleep Medicine
- Autonomic Neuroscience
Background:
- Idiopathic REM sleep behavior disorder (iRBD) is a precursor to neurodegenerative synucleinopathies.
- Autonomic dysfunction is common in iRBD, but large-scale systematic assessment is lacking.
Purpose of the Study:
- To systematically assess autonomic dysfunction in patients with iRBD using a validated scale.
- To compare autonomic symptom profiles between iRBD patients and control groups.
Main Methods:
- A cross-sectional study involving 318 iRBD patients and 318 controls (healthy and other sleep disorder diagnoses).
- Administration of the SCOPA-AUT scale, assessing gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction.
- Data collected from 13 neurological centers across 10 countries between 2008 and 2011.
Main Results:
- iRBD patients exhibited significantly more gastrointestinal, urinary, and cardiovascular dysfunction compared to controls.
- Gastrointestinal dysfunction showed the most prominent differences between iRBD patients and controls.
- Cardiovascular autonomic dysfunction scores in iRBD were intermediate compared to those reported in Parkinson's disease patients.
Conclusions:
- Autonomic symptom assessment is crucial in iRBD patients.
- Collected data can inform prospective studies on the risk of developing neurodegenerative disorders.
- Gastrointestinal motility issues may precede the motor phase of Parkinson's disease.
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