Characterization of de novo Dementia with Lewy Body with different duration of rapid eye movement sleep behavior disorder

Lixin Liu; Zhihong Shi; Jinghuan Gan; Shuai Liu; Chen Wen; Yaqi Yang; Fan Yang; Yong Ji

doi:10.1016/j.sleep.2023.12.025

Characterization of de novo Dementia with Lewy Body with different duration of rapid eye movement sleep behavior disorder

Sleep Med. 2024 Feb:114:101-108. doi: 10.1016/j.sleep.2023.12.025. Epub 2023 Dec 26.

Authors

Lixin Liu¹, Zhihong Shi², Jinghuan Gan³, Shuai Liu², Chen Wen⁴, Yaqi Yang⁵, Fan Yang⁵, Yong Ji⁶

Affiliations

¹ Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; The Psycho Department of Beijing Geriatric Hospital, Beijing, China.
² Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China.
³ Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
⁴ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China.
⁵ Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.
⁶ Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China. Electronic address: jiyongusa@126.com.

PMID: 38176204
DOI: 10.1016/j.sleep.2023.12.025

Abstract

Background: Cognitive disorder, parkinsonism, autonomic dysfunction (AuD) and rapid eye movement sleep behavior disorder (RBD) can occur prior to or simultaneously with Dementia with Lewy Body (DLB) onset. RBD is generally linked with progressive neurodegenerative traits. However, associations between RBD with DLB, RBD without DLB, and RBD duration effects on DLB symptoms remain unclear.

Objectives: To examine DLB symptom frequency and subtypes in RBD, and explore the effects of different RBD onset times on symptoms in de novo DLB patients.

Methods: In this multicenter investigation, we consecutively recruited 271 de novo DLB patients. All had standardized clinical and comprehensive neuropsychological evaluations. Subgroup analyses, performed based on the duration of RBD confirmed by polysomnography before the DLB diagnosis, we compared the proportion of patients with cognitive impairment, parkinsonism, and AuD features between groups.

Results: Parkinsonism and AuD incidences were significantly elevated in DLB patients with RBD when compared with patients without RBD. Subgroup analyses indicated no significant differences in parkinsonism between DLB patients who developed RBD ≥10 years prior to the DLB diagnosis and DLB patients without RBD. The incidence of non-tremor-predominant parkinsonism and AuD was significantly higher in DLB patients whose RBD duration before the DLB diagnosis was <10 years when compared with DLB patients without RBD.

Conclusions: We identified significant symptom and phenotypic variability between DLB patients with and without RBD. Also, different RBD duration effects before the DLB diagnosis had a significant impact on symptomatic phenotypes, suggesting the existence of a slowly progressive DLB neurodegenerative subtype.

Keywords: Autonomic dysfunction; Cognition; Dementia with Lewy bodies; Parkinsonism; Rapid eye movement sleep behavior disorder (RBD).

Publication types

Multicenter Study

MeSH terms

Cognition Disorders* / complications
Cognitive Dysfunction* / complications
Cognitive Dysfunction* / diagnosis
Humans
Lewy Body Disease* / complications
Lewy Body Disease* / diagnosis
Parkinsonian Disorders* / diagnosis
REM Sleep Behavior Disorder*