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Article: Familial α-synucleinopathy spectrum features in patients with psychiatric REM sleep behaviour disorder

TitleFamilial α-synucleinopathy spectrum features in patients with psychiatric REM sleep behaviour disorder
Authors
KeywordsDEPRESSION
NEUROPSYCHIATRY
PARKINSON'S DISEASE
SLEEP DISORDERS
Issue Date30-Jun-2023
PublisherBMJ Publishing Group
Citation
Journal of Neurology, Neurosurgery and Psychiatry, 2023 How to Cite?
Abstract

Background Rapid eye movement (REM) sleep behaviour disorder (RBD) is one of the earliest and most specific prodromes of the a-synucleinopathies including Parkinson's disease (PD). It remains uncertain whether RBD occurring in the context of psychiatric disorders (psy-RBD), although very common, is merely a benign epiphenomenon of antidepressant treatment, or whether it harbours an underlying a-synucleinopathy. We hypothesised that patients with psy-RBD demonstrate a familial predisposition to an a-synucleinopathy.Methods In this case-control-family study, a combination of family history and family study method was used to measure the a-synucleinopathy spectrum features, which included RBD, neurodegenerative prodromal markers and clinical diagnoses of neurodegenerative disorders. We compared the risk of a-synucleinopathy spectrum features in the first-degree relatives (FDRs) of patients with psy-RBD, psychiatric controls and healthy controls.Results There was an increase of a-synucleinopathy spectrum features in the psy-RBD-FDRs, including possible and provisional RBD (adjusted HR (aHR)=2.02 and 6.05, respectively), definite RBD (adjusted OR=11.53) and REM-related phasic electromyographic activities, prodromal markers including depression (aHR=4.74) and probable subtle parkinsonism, risk of prodromal PD and clinical diagnosis of PD/dementia (aHR=5.50), as compared with healthy-control-FDRs. When compared with psychiatric-control-FDRs, psy-RBD-FDRs consistently presented with a higher risk for the diagnosis and electromyographic features of RBD, diagnosis of PD/dementia (aHR=3.91) and risk of prodromal PD. In contrast, psychiatric controls only presented with a familial aggregation of depression.Conclusion Patients with psy-RBD are familially predisposed to a-synucleinopathy. The occurrence of RBD with major depression may signify a subtype of major depressive disorders with underlying a-synucleinopathy neurodegeneration.


Persistent Identifierhttp://hdl.handle.net/10722/331984
ISSN
2023 Impact Factor: 8.7
2023 SCImago Journal Rankings: 2.959
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, Jing-
dc.contributor.authorLam, Siu Ping-
dc.contributor.authorHuang, Bei-
dc.contributor.authorLiu, Yaping-
dc.contributor.authorZhang, Jihui-
dc.contributor.authorYu, Mandy W M-
dc.contributor.authorTsang, Jessie C C-
dc.contributor.authorZhou, Li-
dc.contributor.authorChau, Steven W H-
dc.contributor.authorChan, Ngan Yin-
dc.contributor.authorChan, Joey W Y-
dc.contributor.authorSchenck, Carlos H-
dc.contributor.authorLi, Shirley X-
dc.contributor.authorMok, Vincent C T-
dc.contributor.authorMa, Karen Ka Yan-
dc.contributor.authorChan, Anne Yin Yan-
dc.contributor.authorWing, Yun Kwok-
dc.date.accessioned2023-09-28T05:00:03Z-
dc.date.available2023-09-28T05:00:03Z-
dc.date.issued2023-06-30-
dc.identifier.citationJournal of Neurology, Neurosurgery and Psychiatry, 2023-
dc.identifier.issn0022-3050-
dc.identifier.urihttp://hdl.handle.net/10722/331984-
dc.description.abstract<p>Background Rapid eye movement (REM) sleep behaviour disorder (RBD) is one of the earliest and most specific prodromes of the a-synucleinopathies including Parkinson's disease (PD). It remains uncertain whether RBD occurring in the context of psychiatric disorders (psy-RBD), although very common, is merely a benign epiphenomenon of antidepressant treatment, or whether it harbours an underlying a-synucleinopathy. We hypothesised that patients with psy-RBD demonstrate a familial predisposition to an a-synucleinopathy.Methods In this case-control-family study, a combination of family history and family study method was used to measure the a-synucleinopathy spectrum features, which included RBD, neurodegenerative prodromal markers and clinical diagnoses of neurodegenerative disorders. We compared the risk of a-synucleinopathy spectrum features in the first-degree relatives (FDRs) of patients with psy-RBD, psychiatric controls and healthy controls.Results There was an increase of a-synucleinopathy spectrum features in the psy-RBD-FDRs, including possible and provisional RBD (adjusted HR (aHR)=2.02 and 6.05, respectively), definite RBD (adjusted OR=11.53) and REM-related phasic electromyographic activities, prodromal markers including depression (aHR=4.74) and probable subtle parkinsonism, risk of prodromal PD and clinical diagnosis of PD/dementia (aHR=5.50), as compared with healthy-control-FDRs. When compared with psychiatric-control-FDRs, psy-RBD-FDRs consistently presented with a higher risk for the diagnosis and electromyographic features of RBD, diagnosis of PD/dementia (aHR=3.91) and risk of prodromal PD. In contrast, psychiatric controls only presented with a familial aggregation of depression.Conclusion Patients with psy-RBD are familially predisposed to a-synucleinopathy. The occurrence of RBD with major depression may signify a subtype of major depressive disorders with underlying a-synucleinopathy neurodegeneration.<br></p>-
dc.languageeng-
dc.publisherBMJ Publishing Group-
dc.relation.ispartofJournal of Neurology, Neurosurgery and Psychiatry-
dc.subjectDEPRESSION-
dc.subjectNEUROPSYCHIATRY-
dc.subjectPARKINSON'S DISEASE-
dc.subjectSLEEP DISORDERS-
dc.titleFamilial α-synucleinopathy spectrum features in patients with psychiatric REM sleep behaviour disorder-
dc.typeArticle-
dc.identifier.doi10.1136/jnnp-2022-330922-
dc.identifier.scopuseid_2-s2.0-85165146828-
dc.identifier.eissn1468-330X-
dc.identifier.isiWOS:001025149500001-
dc.identifier.issnl0022-3050-

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