Date: Monday, June 5, 2017
Session Title: Parkinsonism, MSA, PSP (Secondary and Parkinsonism-Plus)
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
To determine the prevalence of rapid eye movement (REM) sleep behavior disorder (RBD) in autopsy confirmed Parkinson disease (PD) and Progressive Supranuclear Palsy (PSP).
The diagnostic accuracy of a clinical diagnosis of PD is low in early stages of the disease. Currently, there is no sensitive and specific biomarker to distinguish between PD and atypical parkinsonism and definitive diagnosis is based on pathology. This study compares the prevalence of RBD in autopsy proven PSP and PD subjects.
Methods: Data was obtained from the Banner Sun Health Research Institute Brain and Body Donation Program. Subjects had annual movement disorders assessments and a clinical diagnosis of PD or PSP was made. The presence of RBD was determined by the Mayo Sleep Questionnaire which was completed by an informant as well as by questioning during the exam and review of records. The prevalence of RBD was then compared in autopsy proven PSP and PD cases. The diagnosis of PSP and PD were based on the standardized neuropathological assessment.
Results: Fifty-six cases of autopsy-confirmed PD and twelve cases of PSP were included in the study. The mean age of death in PSP group was 87.6 years while in PD it was 81.3 years (p=0.005). 9/12 (75%) of PSP and 36/56 (64%) of PD subjects had dementia on clinical examination. RBD was present in 40/56 (71%) PD cases and 0/12 with PSP (p<0.001). The total mean UPDRS III score was higher in the PD group (p<0.05).
Conclusions: Although the PSP cohort is small, RBD was always absent whereas it was frequently present in those with alpha-synucleinopathy. The study supports previous research that the presence of RBD in a parkinsonian patient may indicate an underlying synucleinopathy.
References: 1. Munhoz RP, Teive HA. REM sleep behaviour disorder: how useful is it for the differential diagnosis of parkinsonism? Clin Neurol Neurosurg. 2014 Dec;127:71-74. 2. Nomura T, Inoue Y, Takigawa H, Nakashima K. Comparison of REM sleep behaviour disorder variables between patients with progressive supranuclear palsy and those with Parkinson’s disease. Parkinsonism Relat Disord. 2012 May;18(4):394-396.
To cite this abstract in AMA style:H. Gupta, S. Mehta, J. Hentz, H. Shill, E. Driver-Dunckley, M. Sabbagh, C. Belden, B. Dugger, T. Beach, G. Serrano, L. Sue, C. Adler. REM sleep behavior disorder: Is it useful to differentiate between Parkinson disease and Progressive Supranuclear Palsy? [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/rem-sleep-behavior-disorder-is-it-useful-to-differentiate-between-parkinson-disease-and-progressive-supranuclear-palsy/. Accessed December 10, 2023.
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