Objective: To evaluate the predictive role of cardiovascular diseases and metabolic risk factors in the phenoconversion of idiopathic REM sleep behavior disorder (iRBD) patients.
Background: iRBD is a strong predictive marker for the future development of α-synucleinopathies. It remains unclear whether cardiovascular disorders or metabolic risk factors alter phenoconversion rates or change phenoconversion type.
Method: In this prospective cohort study, patients with polysomnographic-confirmed iRBD who were free of neurodegenerative diseases at baseline were recruited between 2004 and 2021. History of cardiovascular diseases, hypertension, diabetes, and hypercholesterolemia was obtained from all patients. Patients were followed up annually, until the development of neurodegenerative outcomes such as Parkinson’s disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB), diagnosed according to movement disorders society (MDS) criteria. Association between cardiovascular/metabolic risk factors and phenoconversion was calculated using Cox regression model adjusted for age and sex.
Results: A total of 209 patients were diagnosed with iRBD, and follow-up data was available for 183 (75.4% male, age=66.4 (SD=8.3) years). The average time between RBD diagnosis and the last evaluation was 4.38 (SD=3.2) years. Comparing 66 patients who developed outcome (27 PD, 34 DLB, and 5 MSA) with 117 outcome-free patients, no statistically difference was observed in their baseline cardiovascular diseases (13.6% vs. 9.4%, adjusted Hazard Ratio (aHR)=1.03[0.51,2.10]), hypertension (30.3% vs. 29.1%, aHR=1.12[0.66,1.90]), hypercholesterolemia (33.3% vs. 38.5%, aHR=1.06[0.63,1.77]), or diabetes (13.6% vs. 16.2%, aHR=0.88[0.44,1.78]). There were no differences between synucleinopathy subtypes, except for MSA, who had a higher prevalence of baseline hypertension compared to those remaining disease free (60.0% vs. 29.1%, aHR=6.65[1.00,44.40]).
Conclusion: We found no link between cardiovascular diseases, hypertension, diabetes, or hypercholesterolemia and phenoconversion rate from iRBD to defined neurodegenerative disease.
To cite this abstract in AMA style:
N. Lewandowski, S. Zolfaghari, A. Pelletier, S A. Naeimi, J-F. Gagnon, M. Brillon-Corbeil, J. Montplaisir, R. Postuma. Cardiovascular risk factors and phenoconversion to neurodegenerative synucleinopathies in idiopathic REM sleep behavior disorder [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/cardiovascular-risk-factors-and-phenoconversion-to-neurodegenerative-synucleinopathies-in-idiopathic-rem-sleep-behavior-disorder/. Accessed May 17, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/cardiovascular-risk-factors-and-phenoconversion-to-neurodegenerative-synucleinopathies-in-idiopathic-rem-sleep-behavior-disorder/