Objective: To access the interrelation and relative influence of gender, associated neurological disorder and context of referral to PSG on the manifestations of  (RBD).

Background: Symptomatic differences between genders could explain variations in gender prevalence between studies. Debate persists on whether the severity of RBD differs between idiopathic (iRBD) and symptomathic RBD. Patients who spontaneously recurre to  medical consultation for RBD symptoms could present with worse complaints compared to in whom  RDB  was detetcted by screening methods or as an incidental finding. Thus gender, associated neurological disorder and motive for referral to PSG could have a significant influence in RBD manifestations.

Method: 62 RBD patients were assessed with vídeo-polysomnography (PSG) regarding sleep structure, muscular activity and motor events during REM sleep (ME). Patients were categorized according to gender (female n=17), asscoiated neurological disorder (iRBD (n=22) vs.α-synuclein (n=35) vs. non-α-synucleinopathy (n=5) and motive for PSG (direct referral due to RBD symptoms (FIRST, n=13); referred in the course of screening procedures (SCREENING n=13); referred during clinical follow-up for other disorders (n=27);referred for symptoms other than RBD (n=8).

Results: Phasic activity index and myoclonic and trunk ME were significantly higher in men and segmental ME in women. The prevalence of α-synuclein cases was higher in SCREENING and  iRBD in FIRST categories. There was a higher severity of ME in iRBD patients, compared to other diagnostic categories. Global motor severity of ME was significantly higher in FIRST group. In multivariate analysis, both Motive for PSG and Diagnostic Category had a significant and independent influence on the Global Severity of ME .

Conclusion: Our findings suggest that gender, diagnostic category and motive for PSG  can significantly influence RBD presentation. Male gender is related with higher muscular phasic activity and a different pattern of ME, while having iRBD (as opposed to secondary RBD) and being directly referred for a first consultation because of complaints compatible with RBD (as opposed to being diagnosed in a screening procedure or during follow-up for other disorders) are significantly interrelated but independently associated with the global severity of ME during REM sleep.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/the-influence-of-gender-associated-neurological-disorder-and-motive-for-polysomnography-psg-in-the-manifestations-of-rem-sleep-behaviour-disorder-rbd/