Apathy in rapid eye movement sleep behaviour disorder is common and under-recognized
T R Barber1,2, K Muhammed1,3, D Drew1
1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
European Journal of Neurology
|November 9, 2017
Summary
Apathy is common in 46% of patients with Rapid Eye Movement Sleep Behaviour Disorder (RBD), a condition that may precede Parkinson's disease (PD). Apathy in RBD is often missed by standard screening questions.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Apathy is a key neuropsychiatric feature in Parkinson's disease (PD), often appearing before motor symptoms.
- Rapid Eye Movement Sleep Behaviour Disorder (RBD) is a prodromal indicator for future PD development.
- While neuropsychiatric issues are prevalent in RBD, apathy has not been extensively studied in this population.
Purpose of the Study:
- To investigate the prevalence of apathy in patients with RBD.
- To compare apathy levels in RBD patients with those in PD patients and controls.
- To assess the effectiveness of the Unified Parkinson's Disease Rating Scale (UPDRS) in screening for apathy in RBD.
Main Methods:
- Eighty-eight patients with polysomnographically confirmed RBD, 65 PD patients, and 33 controls were evaluated.
- The Lille Apathy Rating Scale (LARS) was used to assess apathy.
- Cognition, depression, and the sensitivity of UPDRS screening questions were also quantified.
Main Results:
- Apathy was present in 46% of RBD patients, versus 31% in PD patients.
- A majority of apathetic RBD patients were not depressed, indicating apathy is a distinct feature.
- The UPDRS apathy screening question showed low sensitivity (33% for mild, 50% for severe apathy).
Conclusions:
- Apathy is a frequent and potentially underestimated symptom in RBD.
- Recognizing apathy as a distinct feature in RBD is crucial for targeted interventions.
- Understanding apathy in RBD may enhance insights into the prodromal stages of PD.
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