title: REM Sleep Behavior and Motor Findings in Parkinson's Disease: A Cross-sectional Analysis.
abstract: BACKGROUND
  Parkinson's disease (PD) represents a major public health challenge that will only grow in our aging population. Understanding the connection between PD and associated prodromal conditions, such as rapid eye movement sleep behavioral disorder (RBD), is critical to identifying prevention strategies. However, the relationship between RBD and severity of motor findings in early PD is unknown. This study aims to examine this relationship.
  
  
  METHODS
  The study population consisted of 418 PD patients who completed the Movement Disorders Society-United Parkinson's Disease Rating Scale (MDS-UPDRS) and rapid eye movement sleep (REM) disorder questionnaires at the baseline visit of the Michael J. Fox's Parkinson's Progression Markers Initiative (PPMI). Cross-sectional analysis was carried out to assess the association between REM Sleep Behavior Screening Questionnaire score and MDS UPDRS-3 (motor) score categories. Correlation with a higher score category was described as "worse motor findings". A score of 5 on the REM disorder questionnaire was defined as predictive of RBD.
  
  
  RESULTS
  Out of the 418 PD patients, 113 (27.0%) had RBD. With univariate logistic regression analysis, individuals with scores predictive of RBD were 1.66 times more likely to have worse motor findings (p = 0.028). Even with age, gender, and Geriatric Depression Scale scores taken into account, individuals with scores predictive of RBD were 1.69 times more likely to have worse motor findings (p = 0.025).
  
  
  CONCLUSIONS
  PD patients with RBD symptoms had worse motor findings than those unlikely to have RBD. This association provides further evidence for the relationship between RBD and PD.
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Liana S
authors.initials: LS
authors.lastname: Rosenthal
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Charlene
authors.initials: C
authors.lastname: Gamaldo
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Salas
authors.affiliation: Department of Psychiatry and Behavioral Sciences Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Pontone
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Arita
authors.initials: A
authors.lastname: McCoy
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Chizoba
authors.initials: C
authors.lastname: Umeh
authors.affiliation: Department of Neurology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mari
keywords: Movement Disorders Society-United Parkinson's Disease Rating Scale; Parkinson's disease; motor findings; rapid eye movement sleep