Objective: Assess the predicitive value of dream content for cognitive dysfuncion progression in Parkinson’s Disease (PD).

Background: PD patients frequently complain of vivid dreams. Cross-sectional studies have suggested a correlation between the presence of agression related content in dream reports and low scores on executive function tests [1]. Dream content alterations have also been associated with  REM sleep behaviour disorder (RBD), psychosis, mood disorders and dopaminergic treatment. There has been no longidutinal study adressing the significance of dream content as a possible marker of cognitive deterioration in PD.

Method: We addressed all consecutive, non-demented PD patients followed at an outpatient clinic for movement disorders during a year interval. Dream reports were collected at baseline by means of  a dream diary and reports were analyzed according to the Hall and van Castle system, to create dream indexes. Baseline assessment protocol included the  REM Sleep Behavioral Disturbance Symptoms Scale (followed by polysomnography, in positive cases)  Hoehn and Yahr scale, the Hospital Anxiety and Depression Rating Scale and Parkinson’s Psychosis Rating Scale. MoCA was applied at baseline and four years latter.  Linear regression analysis was used to the test the relation between each dream index, demographic and other motor and non-motor variables (predictors) and change in MoCA scores (dependent variable).

Results: Dreams were solicited to 98 patients at baseline, of whom 58 were assessed at follow-up (17 were lost, 19 died and 4 changed diagnosis). Of those, 23 patients reported at least one dream (range 1 to 27, total 148).  Aggression, physical activities and negative toned content predominated in patients dreams.  MoCA scores decreased significantly from baseline to follow-up. In the final multivariate model, dreams negative emotions index was the strongest predictor of MoCA decrease at follow-up  (B= 6.305; 95% CI 2.217 to 10.394; p=0.004).

Conclusion: We found a significant positive association between negative emotions in dreams at baseline and deterioration of MoCA scores at 4 four year evolution. These findings suggest that dream content is not only a correlate of cognitive dysfunction in PD, but could be considered a predictor of cognitive deterioration, independent of other factors known to influence either dream content or cognitive deterioration.

References: [1] P. Bugalho, T. Paiva. Dream features in the early stages of Parkinson’s disease. J. Neural. Transmit. 118, 11 (2011), 1613-1619

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-dreams-tell-the-future-dream-content-analysis-as-a-predictor-of-cognitive-deterioration-in-parkinsons-disease/