title: Investigation of autonomic function in idiopathic REM sleep behavior disorder.
abstract: Idiopathic REM sleep behavior disorder (iRBD) has been suggested as an early "pre-motor" stage of Parkinson's disease (PD) in a significant proportion of cases. We investigated autonomic function in 15 consecutive iRBD patients and compared these findings to PD patients and healthy controls. All participants underwent cardiovascular autonomic function testing, and were rated on the COMPASS scale. Symptomatic orthostatic hypotension was present in two iRBD patients, two PD patients and none of the healthy controls. In the tilt table examination, blood pressure changes were similar between iRBD patients and healthy controls. In the PD group, blood pressure drops were more pronounced. In the orthostatic standing test, iRBD patients had higher blood pressure changes than healthy controls. Highest drops were found in PD. Valsalva ratio was lower in iRBD and PD compared to healthy controls. Total COMPASS score was higher in iRBD compared to healthy controls. Highest scores were found in PD. These results support the presence of autonomic dysfunction in iRBD. On several measures, dysfunction was intermediate between healthy controls and PD consistent with the concept that iRBD can be manifestation of synuclein-associated neurodegenerative disorders. Follow-up studies are needed to determine whether iRBD patients with dysfunction on several autonomic domains are at particular risk for developing one of these diseases.
authors: Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors: Birgit
authors: B
authors: Frauscher
authors: Takashi
authors: T
authors: Nomura
authors: Susanne
authors: S
authors: Duerr
authors: Laura
authors: L
authors: Ehrmann
authors: Viola
authors: V
authors: Gschliesser
authors: Gregor K
authors: GK
authors: Wenning
authors: Elisabeth
authors: E
authors: Wolf
authors: Yuichi
authors: Y
authors: Inoue
authors: Birgit
authors: B
authors: Högl
authors: Werner
authors: W
authors: Poewe
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis / Q000503:physiopathology*; D012791:Shy-Drager Syndrome / Q000175:diagnosis / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014636:Valsalva Maneuver / Q000502:physiology