Session Information
Date: Monday, June 20, 2016
Session Title: Parkinsonism, MSA, PSP (secondary and parkinsonism-plus)
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The aim of this study was to perform a cross-sectional comparative analysis of quantitative REM sleep without atonia (RWA) and REM sleep behavior disorder (RBD) in multiple system atrophy (MSA) and Parkinson´s disease (PD).
Background: RBD is a common finding in alpha-synucleinopathies including MSA and PD involves sleep related motor disruption.
Methods: We conducted a prospective polysomnography (PSG) study enrolling 7 MSA (4 men, 5 MSA-P, 2 MSA-C)and 13 PD (7 men) patients with Hoehn and Yahr score ≤ 3 and a history of sleep disorders. Each subject underwent clinical evaluation including MDS-UPDRS/UMSARS according to diagnosis, validated sleep questionnaires (ESS, PDSS-2, RBD-I) and PSG. RBD, sleep related breathing disorder, periodic limb movements in sleep (PLMS), and excessive fragmentary myoclonus (EFM) were diagnosed according to American Academy of Sleep Medicine (AASM) and RWA was quantified according to SINBAR criteria. Statistical analyses were performed using Fishers Exact Test, Student´s T test and Wilcoxon Mann Whitney U test as appropriate.
Results: Mean age at examination was 60 ± 3.0 years in MSA and 66 ± 2.4 years in PD patients, mean disease duration was 3.9 ± 0.6 years in MSA and 7.0 ± 1.3 years in PD (p=0.035). RBD was present in all MSA patients, but only in 54% (7/13) of PD patients (p=0.051). The sensitivity and specificity of a positive history by clinical interview for a diagnosis of RBD according to ICSD3 was 100% and 86%, respectively. There was no difference in frequency of RWA in MSA and PD patients (100% of MSA and 92% (12/13) of PD patients showed RWA), despite the difference in RBD. Additional comorbid sleep disorders were not different between MSA and PD: 86% (6/7) of MSA and 54% (7/13) of PD patients showed PLMS (>15/h), EFM was present in 57% (4/7) of MSA and 31% (4/13) of PD patients. OSA (as defined with an AHI >5/h) was detected in 57% (4/7) of MSA and 54% (7/13) of PD patients. Further questionnaire analyses (ESS, PDSS-2, RBD-I) failed to show any difference between MSA and PD patients.
Conclusions: We confirm findings of the literature that RWA is a prominent finding in both PD and MSA, with all patients of the latter condition having RBD. This is likely to reflect more extensive synucleinopathy brainstem involvement in MSA.
To cite this abstract in AMA style:
C. Kaindlstorfer, G. Wenning, S. Bösch, B. Frauscher, F. Krismer, M. Nocker, G. Ransmayr, C. Scherfler, K. Seppi, A. Stefani, W. Poewe, B. Högl. A polysomnography study of REM sleep without atonia and REM sleep behavior disorder in MSA and PD [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/a-polysomnography-study-of-rem-sleep-without-atonia-and-rem-sleep-behavior-disorder-in-msa-and-pd/. Accessed May 18, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-polysomnography-study-of-rem-sleep-without-atonia-and-rem-sleep-behavior-disorder-in-msa-and-pd/