Objective: To examine longitudinal change in the REM behavior disorder (RBD) in the cohort of at baseline de novo Parkinson’s disease (PD) subjects.

Background: RBD is common in PD and is considered to be the strongest prodromal marker of PD and other synucleinopathies. Longitudinal incidence and clinicobiological correlations of RBD in early PD have been less well defined.

Methods: Parkinson’s Progression Markers Initiative (PPMI) is a longitudinal on-going case-control study of de novo, untreated PD participants at enrollment and matched healthy controls (HC). Participants contribute a wide range of motor and non-motor measures, including biofluids and imaging biomarkers. Possible RBD was defined as REM sleep behaviour disorder Questionnaire (RBDQ) score ≥5.

Results: There were 423 PD subjects and 196 age and gender matched HC at baseline. Longitudinal data at the time of analysis were available for 397 PD subjects at one year, 378 at 2 years and 204 at 3 years. The mean (SD) RBD score changed from 4.1 (2.7) to 4.9 (2.9) (p<0.0001) in PD subjects vs 2.8(2.3) to 2.7(2.3) (p=0.28) in HC. At baseline 38% PD vs 20% HC subjects had RBDQ score ≥5 (p<0.01). At 3 years the respective numbers were 50% vs 16.5%.

Conclusions: As expected, there is significant increase in the prevalence of possible RBD in early PD over time versus no significant change in HC. The study limitation is lack of the polysomnography data to confirm the diagnosis of RBD. Future analysis will establish association of possible RBD with the change in the clinical characteristics of the cohort as well as imaging and biomarkers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-evolution-of-possible-rem-sleep-behavior-disorder-in-early-parkinsons-disease/