Apathy in Parkinson's disease with REM sleep behavior disorder.
J Neurol Sci
; 399: 194-198, 2019 Apr 15.
Article
em En
| MEDLINE
| ID: mdl-30826716
ABSTRACT
OBJECTIVES:
Rapid eye movement (REM) sleep behavior disorder (RBD) in patients with Parkinson's disease (PD) is associated with increased risk of non-motor symptoms. However, the association between RBD and apathy in PD remains unclear.AIMS:
To compare the prevalence and severity of apathy symptoms in PD patients with RBD (PD-RBD+) and without (PD-RBD-). In addition, we explored the association between apathy, depressive symptoms and RBD, taking into consideration the concomitant influence of demographic, disease- and therapy-associated variables.METHODS:
Sixty-four PD patients were evaluated with systematic motor (unified Parkinson's disease rating scale, UPDRS-III) and non-motor assessments. The diagnosis of RBD was based on the international consensus criteria using video-polysomnography. Apathy, sleepiness, depressive symptoms and cognitive performance were assessed using the Starkstein apathy (SAS, cut-offâ¯=â¯14), the Epworth sleepiness (ESS), the Hamilton depression (HAM-D, cut-offâ¯=â¯9) scales and the mini-mental state examination (MMSE), respectively.RESULTS:
Among 64 patients, 26 (40%) had RBD. In the PD-RBD+ group, apathy symptoms were more frequent (52% vs 42%) and more severe (14.3⯱â¯5.8 vs 11.2⯱â¯4.9, pâ¯<â¯0.05), especially in the females (17.3⯱â¯6.0 vs 11.4⯱â¯5.8 in males, pâ¯<â¯0.05) compared to the PD-RBD- group. A high percentage of patients, especially in the PD-RBD+ group (53%), had isolated apathy without increased depressive symptoms. Increased depressive symptoms were also more frequent (50% vs 20%) and more severe in the PD-RBD+ group. The two groups were comparable in respect to demographic and clinical characteristics.CONCLUSIONS:
In PD, RBD is associated with isolated apathy and increased severity of depressive symptoms, independent of medication, motor and other non-motor symptoms. Potential mechanisms underlying this association are discussed.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Transtorno do Comportamento do Sono REM
/
Apatia
Tipo de estudo:
Qualitative_research
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article