Correspondence to: Dr. Michele T. Hu, Department of Neurology, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; E-mail: [email protected]

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Yaping Liu MD, PhD,

Yaping Liu MD, PhD

orcid.org/0000-0002-2015-8775

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

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Michael A. Lawton MPhil,

Michael A. Lawton MPhil

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom

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Christine Lo DPhil, MRCP,

Christine Lo DPhil, MRCP

orcid.org/0000-0002-5671-3881

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

Department of Neurology, Royal Hallamshire Hospital, Sheffield, United Kingdom

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Francesca Bowring M.Sc,

Francesca Bowring M.Sc

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

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Johannes C. Klein MD, PhD,

Johannes C. Klein MD, PhD

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

Department of Neurology, John Radcliffe Hospital, Oxford, United Kingdom

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Agustin Querejeta-Coma MD,

Agustin Querejeta-Coma MD

orcid.org/0000-0001-8289-8552

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

Department of Neurology, John Radcliffe Hospital, Oxford, United Kingdom

Department of Neurology, Infanta Elena University Hospital, Valdemoro, Spain

Department of Neurology, Rey Juan Carlos University Hospital, Móstoles, Spain

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Sangeeta Scotton MBBS, MRCP,

Sangeeta Scotton MBBS, MRCP

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

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Jessica Welch M.Sc,

Jessica Welch M.Sc

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

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Jamil Razzaque M.Sc,

Jamil Razzaque M.Sc

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

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Thomas Barber DPhil, MRCP,

Thomas Barber DPhil, MRCP

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

Department of Neurology, John Radcliffe Hospital, Oxford, United Kingdom

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Yoav Ben-Shlomo PhD, MRCP,

Yoav Ben-Shlomo PhD, MRCP

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom

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Michele T. Hu PhD, FRCP,

Corresponding Author

Michele T. Hu PhD, FRCP

[email protected]

Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

Department of Neurology, John Radcliffe Hospital, Oxford, United Kingdom

Correspondence to: Dr. Michele T. Hu, Department of Neurology, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; E-mail: [email protected]

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First published: 26 August 2021

https://doi.org/10.1002/mds.28763

Citations: 15

Relevant conflicts of interest/financial disclosures: Nothing to report.

Full financial disclosures and author roles may be found in the online version of this article.

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Abstract

Background

Parkinson's disease (PD) comorbid with rapid eye movement sleep behavior disorder (RBD) may show more severe motor and nonmotor symptoms, suggesting a distinct PD subtype.

Objective

The aim of this study was to investigate the impact of RBD on the longitudinal change of motor and nonmotor symptoms in patients with PD.

Methods

Patients with early PD (diagnosed within 3.5 years) recruited from 2010 to 2019 were followed every 18 months in the Oxford Parkinson's Disease Centre Discovery cohort. At each visit, we used standard questionnaires and measurements to assess demographic features and motor and nonmotor symptoms (including RBD, daytime sleepiness, mood, autonomic symptoms, cognition, and olfaction). Data were analyzed with linear mixed effects and Cox regression models. Possible RBD (pRBD) was longitudinally determined according to RBD Screening Questionnaire scores.

Results

A total of 923 patients were recruited (mean age: 67.1 ± 9.59 years; 35.9% female), and 788 had follow-up assessment(s) (mean: 4.8 ± 1.98 years, range: 1.3–8.3). Among them, 33.3% were identified as pRBD (PD + pRBD). Patients with PD + pRBD had more severe baseline symptoms and showed faster progression on Movement Disorder Society-Unified Parkinson's Disease Rating Scale parts I and III, Purdue Pegboard test, and Beck Depression Inventory scores. Moreover, PD + pRBD was associated with an increased level of risk for mild cognitive impairment (hazard ratio [HR] = 1.36, 95% confidence interval [CI]: 1.01–1.83), freezing of gait (HR = 1.42, 95% CI: 1.10–1.86), and frequent falling (HR = 1.62, 95% CI: 1.02–2.60).

Conclusions

Patients with PD + pRBD progress faster on motor, mood, and cognitive symptoms, confirming a more aggressive PD subtype that can be identified at baseline and has major clinical implications. © 2021 International Parkinson and Movement Disorder Society

Open Research

Data Availability Statement

The data that support the findings of this study are available on request from the Oxford Parkinson's Disease Centre Data Access Committee.

Supporting Information

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Volume36, Issue12

December 2021

Pages 2821-2832

Longitudinal Changes in Parkinson's Disease Symptoms with and Without Rapid Eye Movement Sleep Behavior Disorder: The Oxford Discovery Cohort Study

Abstract

Background

Objective

Methods

Results

Conclusions

Open Research

Data Availability Statement

Supporting Information

References

Citing Literature

References

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Longitudinal Changes in Parkinson's Disease Symptoms with and Without Rapid Eye Movement Sleep Behavior Disorder: The Oxford Discovery Cohort Study

Abstract

Background

Objective

Methods

Results

Conclusions

Open Research

Data Availability Statement

Supporting Information

References

Citing Literature

References

Related

Information

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