title: REM sleep behavior disorder: association with motor complications and impulse control disorders in Parkinson's disease.
abstract: OBJECTIVE
  Clinical phenotypes such as old age, longer disease duration, motor disability, akineto-rigid type, dementia and hallucinations are known to be associated with REM sleep behavior disorder (RBD) in Parkinson's disease (PD). However, the relationship between motor fluctuations/impulse control and related behaviors (ICRB) and RBD is not clear. We designed this study to elucidate the clinical manifestations associated with RBD to determine the implications of RBD in PD.
  
  
  METHODS
  In a cross-sectional study, a total of 994 patients with PD were interviewed to determine the presence of RBD and their associated clinical features including motor complications and ICRB.
  
  
  RESULTS
  Of the 944 patients, 578 (61.2%) had clinical RBD. When comparing the clinical features between patients with RBD (RBD group) and without RBD (non-RBD group), older age, longer disease duration, higher Hoehn and Yahr stage (H&Y stage), higher levodopa equivalent daily dose (LEDD), and the existence of wearing off, dyskinesia, freezing, and ICRB, especially punding, were associated with the RBD group compared to the non-RBD group (P < .05 in all). Multivariate analysis showed that motor complications including wearing off, peak dose dyskinesia, and diphasic dyskinesia were the only relevant factors for RBD after adjusting for age and disease duration.
  
  
  CONCLUSIONS
  Motor complications and ICRB are more frequent in patients with RBD than in patients without RBD. In addition, motor complications are related to RBD even after adjusting for age and disease duration.
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Kim
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology and Movement Disorder Center, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: brain@snu.ac.kr.
authors.forename: Beom S
authors.initials: BS
authors.lastname: Jeon
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Ulsan University Hospital, Ulsan, South Korea.
authors.forename: Hui-Jun
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology and Movement Disorder Center, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Gwanhee
authors.initials: G
authors.lastname: Ehm
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Ewha Womans University Mokdong Hospital, South Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Yun
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology and Movement Disorder Center, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Han-Joon
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, South Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Kim
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010300:Parkinson Disease / Q000150:complications*; D020187:REM Sleep Behavior Disorder / Q000209:etiology*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: Impulse control disorder; Motor complication; Parkinson's disease; REM sleep behavior disorders