Objective: To identify potential sleep markers of cognitive impairment in Parkinson’s disease (PD) exploring the relationship between V-PSG findings and clinical features.

Background: Sleep disorders and cognitive impairment are frequently reported in Parkinson’s disease (PD) as disabling “non-motor” symptoms. It is known that REM parasomnias (i.e. REM sleep behavior disorder; RBD) predict dementia in PD while little is known about the neurobiological significance of NREM arousal parasomnia-like episodes such as confusional arousals and arousal-related episodes mimicking RBD (so called pseudo RBD) which have been reported to occur in dementia with Lewy bodies (DLB). We report video-PSG findings in patients with PD with different degree of cognitive impairment.

Methods: 170 PD outpatients to underwent to V-PSG. Based on neuropsychological assessment they were assigned to three groups: the first group (G1) without cognitive impairment; the second group (G2) with mild cognitive impairment and the third group (G3)with dementia.

Results: RBD episodes occurred in 43% of the patients, with its single prevalence figures not significantly varying within the groups. Episodes of NREM-arousal parasomnia-like were recorded in 14 % in the first group, 40% in the second and 50% in the third (p 0.002). Interestingly, other eight patients with cognitive impairment removed V-PSG electrodes during a confusional arousal. At multivariate analysis, cognitive impairment significantly increased the risk of NREM arousal parasomnia-like episodes (OR: 4.90; p value 0.045 – CI 95%).

Conclusions: RBD is the most frequent motor behavioural disorder and it can occur at any stage of PD progression. NREM parasomnia appear as a sleep marker of cognitive impairment in PD and could consider as a sleep disorders of advanced Parkinson’s disease.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/nrem-parasomnias-as-a-marker-of-cognitive-impairment-in-parkinsons-disease/