• Panagiotis Bargiotas, Maria Ntafouli, M Lenard Lachenmayer, Paul Krack, W M Michael Schüpbach, and Claudio L A Bassetti.
• Sleep-Wake-Epilepsy Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland. Electronic address: panagiotis.bargiotas@insel.ch.
• J. Neurol. Sci. 2019 Apr 15; 399: 194-198.

ObjectivesRapid eye movement (REM) sleep behavior disorder (RBD) in patients with Parkinson's disease (PD) is associated with increased risk of non-motor symptoms. However, the association between RBD and apathy in PD remains unclear.AimsTo compare the prevalence and severity of apathy symptoms in PD patients with RBD (PD-RBD+) and without (PD-RBD-). In addition, we explored the association between apathy, depressive symptoms and RBD, taking into consideration the concomitant influence of demographic, disease- and therapy-associated variables.MethodsSixty-four PD patients were evaluated with systematic motor (unified Parkinson's disease rating scale, UPDRS-III) and non-motor assessments. The diagnosis of RBD was based on the international consensus criteria using video-polysomnography. Apathy, sleepiness, depressive symptoms and cognitive performance were assessed using the Starkstein apathy (SAS, cut-off = 14), the Epworth sleepiness (ESS), the Hamilton depression (HAM-D, cut-off = 9) scales and the mini-mental state examination (MMSE), respectively.ResultsAmong 64 patients, 26 (40%) had RBD. In the PD-RBD+ group, apathy symptoms were more frequent (52% vs 42%) and more severe (14.3 ± 5.8 vs 11.2 ± 4.9, p < 0.05), especially in the females (17.3 ± 6.0 vs 11.4 ± 5.8 in males, p < 0.05) compared to the PD-RBD- group. A high percentage of patients, especially in the PD-RBD+ group (53%), had isolated apathy without increased depressive symptoms. Increased depressive symptoms were also more frequent (50% vs 20%) and more severe in the PD-RBD+ group. The two groups were comparable in respect to demographic and clinical characteristics.ConclusionsIn PD, RBD is associated with isolated apathy and increased severity of depressive symptoms, independent of medication, motor and other non-motor symptoms. Potential mechanisms underlying this association are discussed.Copyright © 2019 Elsevier B.V. All rights reserved.

22 keywords...

hide…