Risk Factors for Phenoconversion in Rapid Eye Movement Sleep Behavior Disorder
Hui Zhang1,2, Alex Iranzo3, Birgit Högl4
1Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.
Annals of Neurology
|January 4, 2022
Summary
Idiopathic rapid eye movement sleep behavior disorder (iRBD) patients who are older or use nitrate derivatives face higher neurodegenerative disease risk. Factors like pesticide exposure and rural living may be protective.
Area of Science:
- Neurology
- Sleep Medicine
- Neurodegenerative Diseases
Background:
- Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage for synucleinopathies.
- Identifying predictive factors for neurodegenerative disease conversion in iRBD patients is crucial for early intervention.
Purpose of the Study:
- To investigate environmental, lifestyle, and comorbid factors predicting phenoconversion in a multicenter iRBD cohort.
- To assess the long-term risk of developing parkinsonism or dementia in iRBD patients.
Main Methods:
- A prospective, multicenter study of 319 iRBD patients assessed for environmental/lifestyle factors using a questionnaire.
- Follow-up over 11 years included assessments for parkinsonism or dementia.
- Competing risk analysis and Cox regression were used to evaluate predictive factors, adjusting for age, sex, and center.
Main Results:
- After a mean follow-up of 5.8 years, 46.3% of patients developed neurodegenerative disease.
- Older age and nitrate derivative use increased phenoconversion risk.
- Pesticide exposure, rural living, lipid-lowering, and respiratory medication use were associated with reduced phenoconversion risk.
Conclusions:
- Environmental and lifestyle factors, along with comorbid conditions, significantly predict neurodegenerative disease development in iRBD.
- Findings aid in identifying iRBD patients at higher risk for conditions like Parkinson's disease and dementia.
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