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REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

Published online by Cambridge University Press:  07 May 2020

Zanjbeel Mahmood Open the ORCID record for Zanjbeel Mahmood [Opens in a new window] ,
Ryan Van Patten ,
Marina Z. Nakhla ,
Elizabeth W. Twamley ,
J. Vincent Filoteo  and
Dawn M. Schiehser
Zanjbeel Mahmood
Affiliation:
SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA, USA Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA
Ryan Van Patten
Affiliation:
Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA92093, USA
Marina Z. Nakhla
Affiliation:
SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA, USA Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA
Elizabeth W. Twamley
Affiliation:
Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA92093, USA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA
J. Vincent Filoteo
Affiliation:
Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA92093, USA Department of Neurosciences, Movement Disorders Center, University of California, San Diego, CA, USA
Dawn M. Schiehser*
Affiliation:
Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA92093, USA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA92161, USA
*
*Corresponding Author: Dawn Schiehser, PhD, Research Service, VA San Diego Healthcare System, MC 151-B, La Jolla, CA92161, Email: [email protected]. Phone: +858-552-8585 ext. 2664
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Abstract

Objective:

Rapid eye movement sleep behavior disorder (RBD) affects 33–46% of patients with Parkinson’s disease (PD) and may be a risk factor for neuropsychological and functional deficits. However, the role of RBD on neuropsychological functioning in PD has yet to be fully determined. We, therefore, examined differences in neurocognitive performance, functional capacity, and psychiatric symptoms among nondemented PD patients with probable RBD (PD/pRBD+) and without (PD/pRBD−), and healthy comparison participants (HC).

Methods:

Totally, 172 participants (58 PD/pRBD+; 65 PD/pRBD−; 49 HC) completed an RBD sleep questionnaire, psychiatric/clinical questionnaires, performance-based and self-reported functional capacity measures, and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function.

Results:

Controlling for psychiatric symptom severity, the PD/pRBD+ group had poorer executive functioning and learning performance than the PD/pRBD− group and poorer neuropsychological functioning across all individual cognitive domains than the HCs. In contrast, PD/pRBD− patients had significantly lower scores than HCs only in the language domain. Moreover, PD/pRBD+ patients demonstrated significantly poorer medication management skills compared to HCs. Both PD groups reported greater depressive and anxiety severity compared to HCs; PD/pRBD+ group also endorsed greater severity of apathy compared to HCs.

Conclusions:

The presence of pRBD is associated with poorer neuropsychological functioning in PD such that PD patients with pRBD have poorer cognitive, functional, and emotional outcomes compared to HC participants and/or PD patients without pRBD. Our findings underscore the importance of RBD assessment for improved detection and treatment of neuropsychological deficits (e.g., targeted cognitive interventions).

Keywords

Executive functioningLearningNeuropsychologyFunctional capacityApathyCognition
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 9 , October 2020 , pp. 894 - 905
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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