Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study

Birgit Frauscher; Poul Jennum; Yo-El S Ju; Ronald B Postuma; Isabelle Arnulf; Valerie Cochen De Cock; Yves Dauvilliers; Maria L Fantini; Luigi Ferini-Strambi; David Gabelia; Alex Iranzo; Smaranda Leu-Semenescu; Thomas Mitterling; Masayuki Miyamoto; Tomoyuki Miyamoto; Jacques Y Montplaisir; Wolfgang Oertel; Amélie Pelletier; Paolo Prunetti; Monica Puligheddu; Joan Santamaria; Karel Sonka; Marcus Unger; Christina Wolfson; Marco Zucconi; Michele Terzaghi; Birgit Högl; Geert Mayer; Raffaele Manni

doi:10.1212/WNL.0000000000000247

Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study

Birgit Frauscher, Poul Jennum, Yo-El S Ju, Ronald B Postuma, Isabelle Arnulf, Valerie Cochen De Cock, Yves Dauvilliers, Maria L Fantini, Luigi Ferini-Strambi, David Gabelia, Alex Iranzo, Smaranda Leu-Semenescu, Thomas Mitterling, Masayuki Miyamoto, Tomoyuki Miyamoto, Jacques Y Montplaisir, Wolfgang Oertel, Amélie Pelletier, Paolo Prunetti, Monica PulighedduJoan Santamaria, Karel Sonka, Marcus Unger, Christina Wolfson, Marco Zucconi, Michele Terzaghi, Birgit Högl, Geert Mayer, Raffaele Manni

Department of Clinical Medicine

63 Citations (Scopus)

Abstract

OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.

METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.

RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.

CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.

Original language	English
Journal	Neurology
Volume	82
Issue number	12
Pages (from-to)	1076-1079
Number of pages	4
ISSN	0028-3878
DOIs	https://doi.org/10.1212/WNL.0000000000000247
Publication status	Published - 25 Mar 2014

Keywords

Administration, Inhalation
Aged
Case-Control Studies
Cohort Studies
Comorbidity
Depression
Female
Glucocorticoids
Humans
Male
Middle Aged
Myocardial Ischemia
Questionnaires
REM Sleep Behavior Disorder
Risk Factors
Serotonin Uptake Inhibitors
Smoking

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10.1212/WNL.0000000000000247

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Frauscher, B., Jennum, P., Ju, Y-E. S., Postuma, R. B., Arnulf, I., Cochen De Cock, V., Dauvilliers, Y., Fantini, M. L., Ferini-Strambi, L., Gabelia, D., Iranzo, A., Leu-Semenescu, S., Mitterling, T., Miyamoto, M., Miyamoto, T., Montplaisir, J. Y., Oertel, W., Pelletier, A., Prunetti, P., ... Manni, R. (2014). Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study. Neurology, 82(12), 1076-1079. https://doi.org/10.1212/WNL.0000000000000247

Frauscher, B, Jennum, P, Ju, Y-ES, Postuma, RB, Arnulf, I, Cochen De Cock, V, Dauvilliers, Y, Fantini, ML, Ferini-Strambi, L, Gabelia, D, Iranzo, A, Leu-Semenescu, S, Mitterling, T, Miyamoto, M, Miyamoto, T, Montplaisir, JY, Oertel, W, Pelletier, A, Prunetti, P, Puligheddu, M, Santamaria, J, Sonka, K, Unger, M, Wolfson, C, Zucconi, M, Terzaghi, M, Högl, B, Mayer, G & Manni, R 2014, 'Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study', Neurology, vol. 82, no. 12, pp. 1076-1079. https://doi.org/10.1212/WNL.0000000000000247

@article{bb1694d8e18d4ccdb05234e95ef40eaf,

title = "Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study",

abstract = "OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.",

keywords = "Administration, Inhalation, Aged, Case-Control Studies, Cohort Studies, Comorbidity, Depression, Female, Glucocorticoids, Humans, Male, Middle Aged, Myocardial Ischemia, Questionnaires, REM Sleep Behavior Disorder, Risk Factors, Serotonin Uptake Inhibitors, Smoking",

author = "Birgit Frauscher and Poul Jennum and Ju, {Yo-El S} and Postuma, {Ronald B} and Isabelle Arnulf and {Cochen De Cock}, Valerie and Yves Dauvilliers and Fantini, {Maria L} and Luigi Ferini-Strambi and David Gabelia and Alex Iranzo and Smaranda Leu-Semenescu and Thomas Mitterling and Masayuki Miyamoto and Tomoyuki Miyamoto and Montplaisir, {Jacques Y} and Wolfgang Oertel and Am{\'e}lie Pelletier and Paolo Prunetti and Monica Puligheddu and Joan Santamaria and Karel Sonka and Marcus Unger and Christina Wolfson and Marco Zucconi and Michele Terzaghi and Birgit H{\"o}gl and Geert Mayer and Raffaele Manni",

year = "2014",

month = mar,

day = "25",

doi = "10.1212/WNL.0000000000000247",

language = "English",

volume = "82",

pages = "1076--1079",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams & Wilkins",

number = "12",

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TY - JOUR

T1 - Comorbidity and medication in REM sleep behavior disorder

T2 - a multicenter case-control study

AU - Frauscher, Birgit

AU - Jennum, Poul

AU - Ju, Yo-El S

AU - Postuma, Ronald B

AU - Arnulf, Isabelle

AU - Cochen De Cock, Valerie

AU - Dauvilliers, Yves

AU - Fantini, Maria L

AU - Ferini-Strambi, Luigi

AU - Gabelia, David

AU - Iranzo, Alex

AU - Leu-Semenescu, Smaranda

AU - Mitterling, Thomas

AU - Miyamoto, Masayuki

AU - Miyamoto, Tomoyuki

AU - Montplaisir, Jacques Y

AU - Oertel, Wolfgang

AU - Pelletier, Amélie

AU - Prunetti, Paolo

AU - Puligheddu, Monica

AU - Santamaria, Joan

AU - Sonka, Karel

AU - Unger, Marcus

AU - Wolfson, Christina

AU - Zucconi, Marco

AU - Terzaghi, Michele

AU - Högl, Birgit

AU - Mayer, Geert

AU - Manni, Raffaele

PY - 2014/3/25

Y1 - 2014/3/25

N2 - OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.

AB - OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.

KW - Administration, Inhalation

KW - Aged

KW - Case-Control Studies

KW - Cohort Studies

KW - Comorbidity

KW - Depression

KW - Female

KW - Glucocorticoids

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia

KW - Questionnaires

KW - REM Sleep Behavior Disorder

KW - Risk Factors

KW - Serotonin Uptake Inhibitors

KW - Smoking

U2 - 10.1212/WNL.0000000000000247

DO - 10.1212/WNL.0000000000000247

M3 - Journal article

C2 - 24553425

SN - 0028-3878

VL - 82

SP - 1076

EP - 1079

JO - Neurology

JF - Neurology

IS - 12

ER -

Comorbidity and medication in REM sleep behavior disorder: a multicenter case-control study

Abstract

Keywords

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