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Article: Residual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow-up Study

TitleResidual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow-up Study
Authors
Keywordsdementia with Lewy bodies
REM sleep behavior disorder
treatment
Issue Date2020
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at https://onlinelibrary.wiley.com/journal/15318257
Citation
Movement Disorders, 2020, v. 35 n. 11, p. 2077-2085 How to Cite?
AbstractBackground: The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injurious symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear. Objective: The objective of this study was to determine the rate and correlates of RIS and its association with the risk of neurodegenerative diseases in patients with iRBD. Methods: This was a retrospective cohort study. RIS was defined by the RBD Questionnaire–Hong Kong (RBDQ-HK) as the presence of residual sleep-related injuries or potential injurious behaviors for at least once a month after at least 1 year of treatment. Results: A total of 15 out of 133 (11.3%) patients with iRBD (age at diagnosis = 66.5 ± 7.3 years, 77.4% male) had RIS after 2.7 years of treatment. Patients with RIS were younger at both onset and polysomnography-confirmed diagnosis of iRBD (years, mean ± standard deviation, 56.3 ± 6.9 vs. 61.8 ± 7.6, P = 0.01; 61.2 ± 4.2 vs. 67.2 ± 7.4, P < 0.001, respectively), had more severe behavioral symptoms at diagnosis (both RBDQ-HK total score and behavioral subscore, P = 0.01), and used a higher maximum dose of clonazepam (mg; median [interquartile range], 1.5 [1.0] vs. 1.0 [1.0], P = 0.01). RIS was probably associated with a higher risk of developing dementia with Lewy bodies (adjusted hazard ratio [95% confidence interval], 5.47 [1.71–17.46], adjusted for onset age of RBD), but not Parkinsons's disease in the follow-up. Conclusion: RIS is not uncommon in patients with iRBD despite long-term medication treatment. An earlier onset and more severe clinical profile are associated with RIS. The prediction of RIS toward dementia with Lewy bodies but not PD suggests that RIS may probably help to identify the specific risk of different subtypes of α-synucleinopathy. © 2020 International Parkinson and Movement Disorder Society
Persistent Identifierhttp://hdl.handle.net/10722/293664
ISSN
2021 Impact Factor: 9.698
2020 SCImago Journal Rankings: 3.352
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, J-
dc.contributor.authorLiu, Y-
dc.contributor.authorChau, SWH-
dc.contributor.authorZhang, J-
dc.contributor.authorTsang, J-
dc.contributor.authorYu, MWM-
dc.contributor.authorChan, NY-
dc.contributor.authorChan, JWY-
dc.contributor.authorLi, XS-
dc.contributor.authorHuang, B-
dc.contributor.authorFeng, H-
dc.contributor.authorMok, V-
dc.contributor.authorWing, YK-
dc.date.accessioned2020-11-23T08:20:02Z-
dc.date.available2020-11-23T08:20:02Z-
dc.date.issued2020-
dc.identifier.citationMovement Disorders, 2020, v. 35 n. 11, p. 2077-2085-
dc.identifier.issn0885-3185-
dc.identifier.urihttp://hdl.handle.net/10722/293664-
dc.description.abstractBackground: The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injurious symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear. Objective: The objective of this study was to determine the rate and correlates of RIS and its association with the risk of neurodegenerative diseases in patients with iRBD. Methods: This was a retrospective cohort study. RIS was defined by the RBD Questionnaire–Hong Kong (RBDQ-HK) as the presence of residual sleep-related injuries or potential injurious behaviors for at least once a month after at least 1 year of treatment. Results: A total of 15 out of 133 (11.3%) patients with iRBD (age at diagnosis = 66.5 ± 7.3 years, 77.4% male) had RIS after 2.7 years of treatment. Patients with RIS were younger at both onset and polysomnography-confirmed diagnosis of iRBD (years, mean ± standard deviation, 56.3 ± 6.9 vs. 61.8 ± 7.6, P = 0.01; 61.2 ± 4.2 vs. 67.2 ± 7.4, P < 0.001, respectively), had more severe behavioral symptoms at diagnosis (both RBDQ-HK total score and behavioral subscore, P = 0.01), and used a higher maximum dose of clonazepam (mg; median [interquartile range], 1.5 [1.0] vs. 1.0 [1.0], P = 0.01). RIS was probably associated with a higher risk of developing dementia with Lewy bodies (adjusted hazard ratio [95% confidence interval], 5.47 [1.71–17.46], adjusted for onset age of RBD), but not Parkinsons's disease in the follow-up. Conclusion: RIS is not uncommon in patients with iRBD despite long-term medication treatment. An earlier onset and more severe clinical profile are associated with RIS. The prediction of RIS toward dementia with Lewy bodies but not PD suggests that RIS may probably help to identify the specific risk of different subtypes of α-synucleinopathy. © 2020 International Parkinson and Movement Disorder Society-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at https://onlinelibrary.wiley.com/journal/15318257-
dc.relation.ispartofMovement Disorders-
dc.rightsSubmitted (preprint) Version This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Accepted (peer-reviewed) Version This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectdementia with Lewy bodies-
dc.subjectREM sleep behavior disorder-
dc.subjecttreatment-
dc.titleResidual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow-up Study-
dc.typeArticle-
dc.identifier.emailLi, XS: shirleyx@hku.hk-
dc.identifier.authorityLi, XS=rp02114-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/mds.28210-
dc.identifier.pmid32744735-
dc.identifier.scopuseid_2-s2.0-85088813628-
dc.identifier.hkuros319138-
dc.identifier.volume35-
dc.identifier.issue11-
dc.identifier.spage2077-
dc.identifier.epage2085-
dc.identifier.isiWOS:000554670900001-
dc.publisher.placeUnited States-

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