Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson's disease
ABSTRACT To investigate the frequency and subtypes of mild cognitive impairment (MCI) in idiopathic rapid eye movement sleep behavior disorder (RBD) and Parkinson's disease (PD) in association with RBD.
One hundred and twelve subjects without dementia or major depression including 32 idiopathic RBD patients, 22 PD patients with polysomnography-confirmed RBD, 18 PD patients without RBD, and 40 healthy control subjects, underwent a comprehensive neuropsychological evaluation. We compared the proportion of patients with MCI between groups using standard diagnostic criteria.
MCI was found in 50% of idiopathic RBD patients and 73% of PD patients with RBD. In contrast, only 11% of PD patients without RBD and 8% of control subjects had MCI. The presence of MCI was significantly greater in idiopathic RBD patients and PD patients with RBD than in PD patients without RBD and control subjects. PD patients with RBD also performed worse than idiopathic RBD patients on neuropsychological tests assessing visuoconstructional and visuoperceptual abilities.
In both its association with PD and its idiopathic form, RBD is an important risk factor for MCI. Except for visuoconstructional and visuoperceptual problems, RBD may be an important determinant of cognitive impairment in PD. Ann Neurol 2009;66:39-47.
SourceAvailable from: Keisuke Suzuki[Show abstract] [Hide abstract]
ABSTRACT: Sleep disturbances are a common non-motor feature in patients with Parkinson's disease (PD). Early diagnosis and appropriate management are imperative for enhancing patient quality of life. Sleep disturbances can be caused by multiple factors in addition to age-related changes in sleep, such as nocturnal motor symptoms (rigidity, resting tremor, akinesia, tardive dyskinesia, and the "wearing off" phenomenon), non-motor symptoms (pain, hallucination, and psychosis), nocturia, and medication. Disease-related pathology involving the brainstem and changes in the neurotransmitter systems (norepinephrine, serotonin, and acetylcholine) responsible for regulating sleep structure and the sleep/wake cycle play a role in emerging excessive daytime sleepiness and sleep disturbances. Additionally, screening for sleep apnea syndrome, rapid eye movement sleep behavior disorder, and restless legs syndrome is clinically important. Questionnaire-based assessment utilizing the PD Sleep Scale-2 is useful for screening PD-related nocturnal symptoms. In this review, we focus on the current understanding and management of sleep disturbances in PD.Current Neurology and Neuroscience Reports 03/2015; 15(3):525. DOI:10.1007/s11910-015-0525-5 · 3.67 Impact Factor
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ABSTRACT: We compared the sleep quality indices between patients with mild cognitive impairment (MCI) and normal elderly subjects and analyzed the effects of sleep characteristics on cognitive functions. Cases of MCI patients (320 persons, MCI group) and 630 normal elderly with matched age, gender, and level of education (control group) were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep characteristics. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. There were 110 (34.3 %) and 170 (27 %) cases with sleep disorders in the MCI and control groups, respectively (P < 0.01). There was a significant difference of total PQSI scores between the two groups, and the scores of sleep duration (factor III) and habitual sleep efficiency (factor IV) in the MCI group were significantly lower than those in the control group. Total PQSI scores negatively correlated with MoCA scores and MMSE scores. MoCA scores negatively correlated with scores of the sleep latency (factor II), sleep duration (factor III), and habitual sleep efficiency (factor IV), while MMSE scores negatively correlated with scores of factor III and factor IV. The scores of attention and calculation, reading and language understanding, and visuospatial function (MMSE), and also of visuospatial/executive function, attention, and clockdrawing test (MoCA) in MCI patients without sleep disorders were significantly higher than those in MCI patients with such disorders. The incidence of sleep disorders is higher in patients with MCI, compared with normal elderly. Effects of sleep disorders on cognitive functions are mainly reflected in the state of attention and visuospatial/executive function.Neurophysiology 02/2014; 46(1):88-94. DOI:10.1007/s11062-014-9410-0 · 0.17 Impact Factor
Aktuelle Neurologie 10/2013; 40(08):452-461. DOI:10.1055/s-0033-1355379 · 0.32 Impact Factor