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Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with rapid eye movement sleep behavior disorder: a substudy of the North American Prodromal Synucleinopathy Consortium
Journal article   Open access   Peer reviewed

Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with rapid eye movement sleep behavior disorder: a substudy of the North American Prodromal Synucleinopathy Consortium

Jonathan E Elliott, Brittany R Ligman, Mohini D Bryant-Ekstrand, Allison T Keil, Katherine Powers, Cosette Olivo, Lee E Neilson, Ronald B Postuma, Amélie Pelletier, Jean-François Gagnon, …
Sleep (New York, N.Y.), Vol.47(6), zsae007
06/13/2024
DOI: 10.1093/sleep/zsae007
PMCID: PMC11519033
PMID: 38181205
url
https://doi.org/10.1093/sleep/zsae007View
Published (Version of record) Open Access

Abstract

Rapid eye movement sleep behavior disorder (RBD) is strongly associated with phenoconversion to an overt synucleinopathy, e.g. Parkinson's disease (PD), Lewy body dementia, and related disorders. Comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)-henceforth "neurotrauma" (NT)-increase the odds of RBD by ~2.5-fold and are associated with an increased rate of service-connected PD in Veterans. Thus, RBD and NT are both independently associated with PD; however, it is unclear how NT influences neurological function in patients with RBD. Participants ≥18 years with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 through the North American Prodromal Synucleinopathy Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory, and autonomic function, were completed. This cross-sectional analysis compared cases (n = 24; RBD + NT) to controls (n = 96; RBD), matched for age (~60 years), sex (15% female), and years of education (~15 years). RBD + NT reported earlier RBD symptom onset (37.5 ± 11.9 vs. 52.2 ± 15.1 years of age) and a more severe RBD phenotype. Similarly, RBD + NT reported more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to RBD. No differences in olfaction or color vision were observed. This cross-sectional, matched case:control study shows individuals with RBD + NT have significantly worse neurological measures related to common features of an overt synucleinopathy. Confirmatory longitudinal studies are ongoing; however, these results suggest RBD + NT may be associated with more advanced neurological symptoms related to an evolving neurodegenerative process.
 Comorbidity Aged Autonomic Nervous System Diseases - epidemiology Autonomic Nervous System Diseases - physiopathology Brain Injuries, Traumatic - complications Brain Injuries, Traumatic - physiopathology Cognitive Dysfunction - epidemiology Cognitive Dysfunction - etiology Cognitive Dysfunction - physiopathology Cross-Sectional Studies Female Humans Male Middle Aged Parkinson Disease - complications Parkinson Disease - epidemiology Parkinson Disease - physiopathology Polysomnography Prodromal Symptoms REM Sleep Behavior Disorder - epidemiology REM Sleep Behavior Disorder - physiopathology Stress Disorders, Post-Traumatic - epidemiology Stress Disorders, Post-Traumatic - physiopathology Synucleinopathies - complications Synucleinopathies - epidemiology Synucleinopathies - physiopathology

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