Journal article
Apathy in Parkinson's disease with REM sleep behavior disorder.
- Bargiotas P Sleep-Wake-Epilepsy Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland. Electronic address: panagiotis.bargiotas@insel.ch.
- Ntafouli M Sleep-Wake-Epilepsy Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
- Lachenmayer ML Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
- Krack P Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
- Schüpbach WMM Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
- Bassetti CLA Sleep-Wake-Epilepsy Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
- 2019-03-04
Published in:
- Journal of the neurological sciences. - 2019
Apathy
Depression
Mood disturbances
Non-motor symptoms
Parkinson's disease
REM parasomnia
REM sleep behavior disorder (RBD)
Sleep-wake disturbances
Aged
Apathy
Female
Humans
Male
Middle Aged
Parkinson Disease
Polysomnography
Quality of Life
REM Sleep Behavior Disorder
Surveys and Questionnaires
Symptom Assessment
English
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-off = 14), the Epworth sleepiness (ESS), the Hamilton depression (HAM-D, cut-off = 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 ± 5.8 vs 11.2 ± 4.9, p < 0.05), especially in the females (17.3 ± 6.0 vs 11.4 ± 5.8 in males, p < 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.
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-off = 14), the Epworth sleepiness (ESS), the Hamilton depression (HAM-D, cut-off = 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 ± 5.8 vs 11.2 ± 4.9, p < 0.05), especially in the females (17.3 ± 6.0 vs 11.4 ± 5.8 in males, p < 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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jns.2019.02.028
- PMID 30826716
- Persistent URL
- https://sonar.ch/global/documents/185345
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