title: Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study.
abstract: Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction. Our results show that compared to control subjects with a similar overall age and sex distribution, patients with iRBD experience significantly more problems with gastrointestinal, urinary, and cardiovascular functioning. The most prominent differences in severity of autonomic symptoms between our iRBD patients and controls emerged in the gastrointestinal domain. Interestingly, it has been reported that an altered gastrointestinal motility can predate the motor phase of PD. The cardiovascular domain SCOPA-AUT score in our study in iRBD patients was intermediate with respect to the scores reported in PD patients by other authors. Our findings underline the importance of collecting data on autonomic symptoms in iRBD. These data may be used in prospective studies for evaluating the risk of developing neurodegenerative disorders.
authors.affiliation: Department of Clinical Neuroscience, Sleep Disorders Center, Università Vita-Salute San Raffaele, Via Stamira d' Ancona 20, 20127, Milan, Italy, ferinistrambi.luigi@hsr.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Oertel
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Postuma
authors.forename: Sara
authors.initials: S
authors.lastname: Marelli
authors.forename: Alex
authors.initials: A
authors.lastname: Iranzo
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
authors.forename: Högl
authors.initials: H
authors.lastname: Birgit
authors.forename: Raffaele
authors.initials: R
authors.lastname: Manni
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Maria-Livia
authors.initials: ML
authors.lastname: Fantini
authors.forename: Monica
authors.initials: M
authors.lastname: Puligheddu
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.forename: Karel
authors.initials: K
authors.lastname: Sonka
authors.forename: Joan
authors.initials: J
authors.lastname: Santamaria
authors.forename: Marco
authors.initials: M
authors.lastname: Zucconi
authors.forename: Paola M V
authors.initials: PM
authors.lastname: Rancoita
authors.forename: Smeranda
authors.initials: S
authors.lastname: Leu-Semenescu
authors.forename: Birgit
authors.initials: B
authors.lastname: Frauscher
authors.forename: Michele
authors.initials: M
authors.lastname: Terzaghi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Marcus
authors.initials: M
authors.lastname: Unger
authors.forename: Karin
authors.initials: K
authors.lastname: Stiasny-Kolster
authors.forename: Alex
authors.initials: A
authors.lastname: Desautels
authors.forename: Christina
authors.initials: C
authors.lastname: Wolfson
authors.forename: Amélie
authors.initials: A
authors.lastname: Pelletier
authors.forename: Jacques
authors.initials: J
authors.lastname: Montplaisir
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric