Quantitative sudomotor abnormalities in clinically isolated rapid eye movement sleep behavior disorder
J Zitser1, S Muppidi2, D I Sinn2
1Global Brain Health Institute, Department of Neurology & Neurological Sciences, University of California, San Francisco, San Francisco, CA, United States of America; Movement Disorders Unit, Department of Neurology, Tel Aviv Sourazky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Background:
Post-ganglionic sudomotor abnormalities are common in Parkinson's disease (PD), however data in clinically isolated REM sleep behavior disorder (iRBD) are limited.
Objective:
To determine the prevalence of sudomotor abnormalities in a cohort of patients with iRBD.
Methods:
We performed a retrospective review of patients seen in our autonomic clinic who underwent testing with the quantitative sudomotor axon reflex test (QSART). We identified three groups for comparison: 1.) iRBD, 2.) PD with RBD (PDwRBD) 3.) PD without RBD (PDwoRBD).
Results:
PDwRBD (n = 27) patients demonstrated the greatest sudomotor abnormalities (sudomotor CASS 1.44 ± 1.24), followed by PDwoRBD (n = 23, 0.57 ± 0.5) and iRBD (n = 20, 0.55 ± 0.94) (p = 0.015). Twenty percent of patients with iRBD had an abnormal result, compared to 67% PDwRBD and 35% PDwoRBD.
Discussion:
Sudomotor abnormalities are common in patients with iRBD, supporting the concept that peripheral autonomic impairment occurs early in the course of disease.
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