title: Parkinson's disease and REM sleep behavior disorder result in increased non-motor symptoms.
abstract: OBJECTIVE
  Rapid eye movement (REM)-sleep behavior disorder (RBD) is often comorbid with Parkinson's disease (PD). The current study aimed to provide a detailed understanding of the impact of having RBD on multiple non-motor symptoms (NMS) in patients with PD.
  
  
  METHODS
  A total of 86 participants were evaluated for RBD and assessed for multiple NMS of PD. Principal component analysis was utilized to model multiple measures of NMS in PD, and a multivariate analysis of variance was used to assess the relationship between RBD and the multiple NMS measures. Seven NMS measures were assessed: cognition, quality of life, fatigue, sleepiness, overall sleep, mood, and overall NMS of PD.
  
  
  RESULTS
  Among the PD patients, 36 were classified as having RBD (objective polysomnography and subjective findings), 26 as not having RBD (neither objective nor subjective findings), and 24 as probably having RBD (either subjective or objective findings). RBD was a significant predictor of increased NMS in PD while controlling for dopaminergic therapy and age (p=0.01). The RBD group reported more NMS of depression (p=0.012), fatigue (p=0.036), overall sleep (p=0.018), and overall NMS (p=0.002).
  
  
  CONCLUSIONS
  In PD, RBD is associated with more NMS, particularly increased depressive symptoms, sleep disturbances, and fatigue. More research is needed to assess whether PD patients with RBD represent a subtype of PD with different disease progression and phenomenological presentation.
authors.affiliation: SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors.forename: Ariel B
authors.initials: AB
authors.lastname: Neikrug
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Avanzino
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA; Department of Veterans Affairs, San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA.
authors.forename: Lianqi
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Maglione
authors.affiliation: Department of Family and Preventative Medicine, University of California, San Diego, CA, USA.
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.affiliation: Department of Neurosciences, University of California, San Diego, CA, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Corey-Bloom
authors.affiliation: SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Medical Research Foundation, San Diego, CA, USA.
authors.forename: Barton W
authors.initials: BW
authors.lastname: Palmer
authors.affiliation: Department of Medicine, University of California, San Diego, CA, USA.
authors.forename: Jose S
authors.initials: JS
authors.lastname: Loredo
authors.affiliation: SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Department of Veterans Affairs, San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA; Veterans Medical Research Foundation, San Diego, CA, USA; Department of Medicine, University of California, San Diego, CA, USA. Electronic address: sancoliisrael@ucsd.edu.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
mesh_terms: D000339:Affect; D000368:Aged; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D017286:Polysomnography; D011788:Quality of Life / Q000523:psychology; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012893:Sleep Wake Disorders / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: Daytime sleepiness; Fatigue; Mood; Non-motor symptoms; Parkinson’s disease; Quality of life; REM sleep behavior disorder; Sleep disorders