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Mild behavioral impairment in idiopathic REM sleep behavior disorder and Lewy body disease continuum

Bora Jin1, Eun Jin Yoon2,3, Kyung Ah Woo4

  • 1Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University of College of Medicine, Seoul, Republic of Korea.

Journal of Neural Transmission (Vienna, Austria : 1996)
|January 9, 2025
PubMed

Insights

Mild behavioral impairment (MBI) correlates with disease severity in Lewy body disease (LBD) continuum patients. The MBI Checklist (MBI-C) shows diagnostic value in differentiating cognitive stages and predicting phenoconversion risk in idiopathic REM sleep behavior disorder (iRBD).

Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Psychology

Background:

  • Lewy body disease (LBD) continuum encompasses idiopathic REM sleep behavior disorder (iRBD) and clinically established LBD.
  • Mild behavioral impairment (MBI) is increasingly recognized as a significant clinical feature in neurodegenerative disorders.
  • Understanding MBI's impact is crucial for assessing disease severity and progression across the LBD spectrum.

Purpose of the Study:

  • To investigate the clinical impact and diagnostic utility of MBI, assessed via the MBI Checklist (MBI-C), in patients with LBD continuum.
  • To examine the association between MBI-C scores and clinical/cognitive measures, including disease severity and cognitive impairment.
  • To evaluate MBI-C's ability to predict phenoconversion risk in iRBD patients.

Main Methods:

  • Eighty-four patients within the LBD continuum (35 iRBD, 49 LBD) were assessed.
  • Evaluations included the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), neuropsychological tests, and the MBI Checklist (MBI-C).
  • Participants were categorized into cognitively normal (CN), mild cognitive impairment (MCI), and dementia groups.

Main Results:

  • MBI-C total scores significantly increased across CN, MCI, and dementia groups (median scores: 1.0, 8.0, 18.5, respectively; p < 0.001).
  • MBI-C scores strongly correlated with MDS-UPDRS scores (r=0.504-0.508, p < 0.001) and cognitive deficits in frontal/executive and attentional domains.
  • MBI-C demonstrated diagnostic value, differentiating MCI from CN (AUC=0.74) and high-risk from low-risk iRBD patients (AUC=0.72).

Conclusions:

  • The MBI Checklist (MBI-C) serves as a valuable screening tool reflecting clinical severity across the Lewy body disease continuum.
  • MBI-C effectively distinguishes between cognitive stages and identifies individuals at higher risk of phenoconversion within iRBD.
  • Further longitudinal studies are warranted to establish MBI-C's role in monitoring disease progression in prodromal LBD.
Keywords:
Dementia with Lewy bodiesIdiopathic REM sleep behavior disorderLewy body diseaseMild behavioral impairmentParkinson’s disease

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