A Questionnaire-Based Study on Clinical REM Sleep Behavior Disorder and Subtypes in Multiple System Atrophy

Area of Science:

• Neurology
• Sleep Medicine
• Neurodegenerative Diseases

Background:

• Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment.
• Multiple system atrophy (MSA) is a rare, progressive neurodegenerative disease with subtypes MSA-P (predominantly parkinsonian) and MSA-C (predominantly cerebellar).
• The association between RBD and MSA subtypes requires further investigation.

Purpose of the Study:

• To investigate the prevalence and severity of clinical RBD in patients with MSA.
• To compare RBD prevalence and severity between MSA-P and MSA-C subtypes.
• To explore the correlation between RBD severity and clinical characteristics in MSA patients.

Main Methods:

• A cohort of 54 consecutive MSA patients and 100 healthy controls (HC) were evaluated.
• Clinical diagnosis and severity of RBD were assessed using standardized criteria and a digital scale.
• Patients were categorized into MSA-P and MSA-C subgroups for comparative analysis.

Main Results:

• The frequency of clinical RBD was significantly higher in MSA patients (70.4%) compared to HC (5%).
• No significant differences in RBD prevalence or severity were found between MSA-P and MSA-C subtypes.
• A negative correlation was observed between RBD severity and preceding motor symptoms in MSA-C patients.

Conclusions:

• Clinical RBD is common in MSA patients, regardless of subtype.
• While prevalence is similar, RBD severity preceding motor symptoms may differ between MSA subtypes, suggesting potential shared pathological mechanisms.
• RBD may serve as an indicator for sleep disturbances in MSA.