Objective: The aim of this study was to investigate the prevalence of RBD in advanced PD patients and to compare the clinical characteristics of advanced PD patients with motor fluctuation with RBD (video-polysomnographically -vPSG- confirmed) with those without RBD.
Background: REM sleep behavior disorder (RBD) heralds the motor manifestation of Parkinson’s Disease (PD). It has also been hypothesized to be a progression marker in clinically overt PD.
Method: All advanced PD patients (Hoehn and Yahr Stage >=3) with motor fluctuations who underwent one-night vPSG because of any nocturnal complaint between January 2010 and December 2018 in the Paracelsus-Elena Hospital, Kassel were included. RBD was diagnosed using the International Classification of Sleep Disorders (ICSD) criteria in effect at the time when the vPSG was performed. Demographic characteristics and comorbidities of patients with and without RBD were compared.
Results: We identified 510 advanced PD patients with valid PSGs. In 37 cases REM sleep could not be evaluated due to artefacts (16 patients) or absence of REM sleep in the vPSG night (21 patients) due to severely disturbed sleep. A total of 473 PD patients with motor fluctuations and valid REM sleep were included: 412 patients were scored with RBD and compared with 56 PD patients without RBD. 5 patients showed only minor REM behavioral events (RBEs) not fulfilling diagnostic criteria for RBD. Therefore, RBD occurred in 87.1 % of patients with advanced PD. PD patients with RBD were significantly older and had more frequently the diagnosis of clinically relevant dementia than those without RBD (69.33 ± 0.02 years vs 64.48 ±9.17 years, p<0.0001; 20.87% vs 5.36%, p=0,0056). No difference was observed regarding mild cognitive impairment, dyskinesias, arterial hypertension or diabetes.
Conclusion: RBD is a frequent feature in patients with advanced PD with motor fluctuations. Age and the presence of dementia is significantly higher in PD patients with RBD than in those without RBD, possibly implying a more severe progression of neurodegeneration PD patients with RBD.
To cite this abstract in AMA style:
M.L Muntean, F. Sixel-Döring, C. Trenkwalder. High prevalence of REM sleep behavior disorder (RBD) in advanced, fluctuating Parkinson’s disease (PD) patients: comparison of clinical parameters between PD patients with and without RBD [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/high-prevalence-of-rem-sleep-behavior-disorder-rbd-in-advanced-fluctuating-parkinsons-disease-pd-patients-comparison-of-clinical-parameters-between-pd-patients-with-and-without-rbd/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/high-prevalence-of-rem-sleep-behavior-disorder-rbd-in-advanced-fluctuating-parkinsons-disease-pd-patients-comparison-of-clinical-parameters-between-pd-patients-with-and-without-rbd/