0078 Parkinson's Disease Patients with Probable REM Behavior Disorder Have Greater Executive Control Impairments than PD Patients without Probable RBD. (12th April 2019)

• Record Type: Journal Article
• Authors: Trout, Jonathan; Christiansen, Taylor; Bulkley, M Brooks; Escobar, Ariel; Tanner, Jared J; Bowers, Dawn; Kay, Daniel B
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A32
• Page End: A33
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.077
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Parkinson's disease (PD) is a neurodegenerative and multisystem movement disorder associated with cognitive and sleep impairments. REM Sleep Behavior Disorder (RBD) is a harbinger of PD and its presence may represent a more severe disease prognosis. We investigated whether the PD patients with probable RBD (n=19) had greater cognitive impairment than PD patients without RBD symptoms (n=31) or healthy matched controls (n=47). Methods: Participants received a clinical sleep assessment and a comprehensive neuropsychological examination. Probable RBD was determined using the REM Sleep Behavior Disorder Screening Questionnaire (total score >5). PD severity was determined using a modified Hoehn-Yahr Scale and PD duration. Cognitive flexibility (i.e., color, word, inhibition, and switching speed) and verbal fluency (i.e., category, letter, and switching responses and accuracy) were assessed with the Delis-Kaplan Executive Function System subtests, working memory was assessed using accuracy on the 2- and 3-back tests, sustained visual attention was evaluated using a Continuous Performance Task, and visuospatial skills were measured using the Benton Judgment of Line Orientation test. Mann-Whitney U and t-tests were employed to analyze differences between groups (all PD patients vs. matched controls and PD patients with RBD vs. PD patients without RDB). Results: PD patients had poorer sustained attention, working memory (3-back), and visuospatial skills than controls: Z=-2.59, p<0.01, Z=-2.31, p<0.021, Z=-2.54, p<0.011, respectively. PD patients with probable RBD had poorer performance on cognitive flexibility tasks including word reading, switching verbal fluency, and category verbal fluency than the PD patients without RBD: Z=-2.49, p<0.013, Z=-2.26, p<0.024, t=2.51, p<0.016, respectively. PD severity did not differ in patients with or without probable RBD (p>0.05). Conclusion: Given comparable disease duration and severity, the presence of probable RBD in PD was associated with greater executive function impairments than PD alone. RBD in PD may be associated with advanced impairment in brain circuitry implicated in verbal executive functions (i.e., left frontoparietal cortices). Support (If Any)