REM Sleep Behavior Disorder and Cognitive Impairment in Parkinson’s Disease

Jun 25, 2017Sleep

Sleep Movement Problems During Dreaming and Thinking Difficulties in Parkinson's Disease

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Mild cognitive impairment (MCI) diagnosis frequency was almost threefold higher in Parkinson's disease patients with REM sleep behavior disorder (RBD) compared to those without RBD (66% vs. 23%, p < .001).

Parkinson's disease patients with RBD exhibited poorer cognitive performance on multiple tests compared to those without RBD and healthy subjects.
No significant differences were observed in cognitive measures between PD patients without RBD and healthy subjects.
Subjective cognitive decline was reported by 89% of PD patients with RBD, versus 58% of those without RBD (p = .024).
The findings suggest that RBD may be linked to more severe cognitive deficits in nondemented PD patients.

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STUDY OBJECTIVES: REM sleep behavior disorder (RBD) is a parasomnia affecting 33% to 46% of patients with Parkinson's disease (PD). The existence of a unique and specific impaired cognitive profile in PD patients with RBD is still controversial. We extensively assessed cognitive functions to identify whether RBD is associated with more severe cognitive deficits in nondemented patients with PD.

METHODS: One hundred sixty-two participants, including 53 PD patients with RBD, 40 PD patients without RBD, and 69 healthy subjects, underwent polysomnography, a neurological assessment and an extensive neuropsychological exam to assess attention, executive functions, episodic learning and memory, visuospatial abilities, and language.

RESULTS: PD patients with RBD had poorer and clinically impaired performance in several cognitive tests compared to PD patients without RBD and healthy subjects. These two latter groups were similar on all cognitive measures. Mild cognitive impairment (MCI) diagnosis frequency was almost threefold higher in PD patients with RBD compared to PD patients without RBD (66% vs. 23%, p < .001). Moreover, subjective cognitive decline was reported in 89% of PD patients with RBD compared to 58% of PD patients without RBD (p = .024).

CONCLUSIONS: RBD in PD is associated with a more impaired cognitive profile and higher MCI diagnosis frequency, suggesting more severe and widespread neurodegeneration. This patient subgroup and their caregivers should receive targeted medical attention to better detect and monitor impairment and to enable the development of management interventions for cognitive decline and its consequences.

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REM Sleep Behavior Disorder and Cognitive Impairment in Parkinson’s Disease

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