Tuesday 19 April 2016

Association between REM sleep behaviour disorder and impulse control disorder in patients with Parkinson's disease

Interesting result here... although perhaps unsurprising given that both occur (to a greater extent) in more severe PD... important to note that dopamine agonists cause other sleep-related side effects that may be mis-reported as RBD especially in self-report brief screening tests. Previous groups have actually reported benefit from dopamine agonists in those with RBD... I guess in light of these data such approaches might need a rethink...

Neurologia. 2016 Apr 14. pii: S0213-4853(16)00117-1. doi: 10.1016/j.nrl.2016.02.008. [Epub ahead of print]
Bellosta Diago E, Lopez Del Val LJ, Santos Lasaosa S, López Garcia E, Viloria Alebesque A.

INTRODUCTION:
The relationship between impulse control disorder (ICD) and REM sleep behaviour disorder (RBD) has not yet been clarified, and the literature reports contradictory results. Our purpose is to analyse the association between these 2 disorders and their presence in patients under dopaminergic treatment.

METHODS:
A total of 73 patients diagnosed with Parkinson's disease and treated with a single dopamine agonist were included in the study after undergoing clinical assessment and completing the single-question screen for REM sleep behaviour disorder and the short version of the questionnaire for impulsive-compulsive behaviours in Parkinson's disease.

RESULTS:
Mean age was 68.88 ± 7.758 years. Twenty-six patients (35.6%) were classified as probable-RBD. This group showed a significant association with ICD (P=.001) and had a higher prevalence of non-tremor akinetic rigid syndrome and longer duration of treatment with levodopa and dopamine agonists than the group without probable-RBD. We found a significant correlation between the use of oral dopamine agonists and ICD. Likewise, patients treated with oral dopamine agonists demonstrated a greater tendency toward presenting probable-RBD than patients taking dopamine agonists by other routes; the difference was non-significant.

CONCLUSIONS:

The present study confirms the association between RBD and a higher risk of developing symptoms of ICD in Parkinson's disease.

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