Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case–control study

Luigi Ferini-Strambi, Wolfgang Oertel, Yves Dauvilliers, Ronald B Postuma, Sara Marelli, Alex Iranzo, Isabelle Arnulf, Högl Birgit, Raffaele Manni, Tomoyuki Miyamoto, Maria-Livia Fantini, Monica Puligheddu, Poul Jennum, Karel Sonka, Joan Santamaria, Marco Zucconi, Paola M V Rancoita, Smeranda Leu-Semenescu, Birgit Frauscher, Michele TerzaghiMasayuki Miyamoto, Marcus Unger, Karin Stiasny-Kolster, Alex Desautels, Christina Wolfson, Amélie Pelletier, Jacques Montplaisir

    66 Citationer (Scopus)

    Abstract

    Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction. Our results show that compared to control subjects with a similar overall age and sex distribution, patients with iRBD experience significantly more problems with gastrointestinal, urinary, and cardiovascular functioning. The most prominent differences in severity of autonomic symptoms between our iRBD patients and controls emerged in the gastrointestinal domain. Interestingly, it has been reported that an altered gastrointestinal motility can predate the motor phase of PD. The cardiovascular domain SCOPA-AUT score in our study in iRBD patients was intermediate with respect to the scores reported in PD patients by other authors. Our findings underline the importance of collecting data on autonomic symptoms in iRBD. These data may be used in prospective studies for evaluating the risk of developing neurodegenerative disorders.
    OriginalsprogEngelsk
    TidsskriftJournal of Neurology
    Vol/bind261
    Udgave nummer6
    Sider (fra-til)1112-1118
    Antal sider7
    ISSN0340-5354
    DOI
    StatusUdgivet - jun. 2014

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