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REM sleep behavior disorder in Japanese patients with Parkinson’s disease: a multicenter study using the REM sleep behavior disorder screening questionnaire

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Abstract

REM sleep behavior disorder (RBD) is known to be observed more frequently in patients with an α-synucleinopathy such as Parkinson’s disease (PD) than in the general population. The precise prevalence of RBD in Japanese PD patients is not known. Therefore, we investigated the prevalence and the clinical characteristics of patients with RBD in a large population of Japanese patients with PD. We investigated various clinical features and employed the Japanese version of the RBD screening questionnaire on 469 non-demented Japanese PD patients in this multicenter study. Probable or possible RBD was detected in 146 patients (31.1%) and was significantly associated with longer PD duration, higher Hoehn and Yahr stage, higher Unified Parkinson’s Disease Rating Scale part III subscale (7 items), more motor fluctuations, and a higher levodopa-equivalent daily dose (p < 0.01). As to the major autonomic dysfunctions, severe constipation was significantly more frequent in PD patients with RBD than in those without it (p < 0.01). The RBD symptoms of 53 patients (39.0%) preceded the onset of PD motor symptoms. The median interval from the onset of RBD symptoms to PD motor symptoms was 17.5 years, and 3 patients had intervals of over 50 years. This large-scale multicenter study revealed that RBD is a frequent non-motor symptom in Japanese patients with PD, which may precede the onset of motor symptoms. Moreover, RBD that increases with the duration and severity of PD may be associated with autonomic dysfunction.

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Author information

Authors and Affiliations

  1. Department of Neurology, Keio University School of Medicine, 35-Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yoshihiro Nihei, Kazushi Takahashi, Morinobu Seki & Norihiro Suzuki

  2. Department of Neurology, Yomiuri Land Keiyu Hospital, 3294-Yanokuchi, Inagi, Tokyo, 206-0812, Japan

    Atsuo Koto

  3. Department of Neurology, Mihara Memorial Hospital, 366-Ohtamachi, Isesaki, Gunma, 372-0006, Japan

    Ban Mihara

  4. Department of Neurology, National Hospital Organization Tokyo Medical Center, 2-5-1-Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan

    Yoko Morita

  5. Department of Neurology, Ashikaga Red Cross Hospital, 284-1-Yobecho, Ashikaga, Tochigi, 326-0843, Japan

    Kazuo Isozumi

  6. Department of Neurology, Tachikawa Hospital, 4-2-22, Nishikicho, Tachikawa, Tokyo, 190-8531, Japan

    Kouichi Ohta

  7. Department of Neurology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1-Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan

    Kazuhiro Muramatsu

  8. Department of Neurology, Saiseikai Central Hospital, 1-4-17-Mita, Minato-ku, Tokyo, 108-0073, Japan

    Jun Gotoh

  9. Department of Neurology, Mito Red Cross Hospital, 3-12-48-Sannomaru, Mito, Ibaraki, 310-0011, Japan

    Keiji Yamaguchi

  10. Department of Neurology, Tomita Hospital, 26-Minaminakamachi, Motojukucho-aza, Okazaki, Aichi, 444-3505, Japan

    Yutaka Tomita

  11. Department of Neurology, Saitama Municipal Hospital, 2460-Mimuro, Midori-ku, Saitama, 336-8522, Japan

    Hideki Sato

  12. Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35-Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Satoko Iwasawa

Authors
  1. Yoshihiro Nihei
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  2. Kazushi Takahashi
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  14. Satoko Iwasawa
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  15. Norihiro Suzuki
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Corresponding author

Correspondence to Kazushi Takahashi.

Additional information

On behalf of Keio Parkinson’s Disease Database.

A list of the members of the Keio Parkinson’s Disease database is provided in Appendix.

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Supplementary Table 1 (PDF 84 kb)

Appendix

Appendix

The members of the Keio Parkinson’s Disease database are: Chair: Norihiro Suzuki, MD, PhD, Keio University School of Medicine, Tokyo, Japan. Members: Yoshihiro Nihei, MD, Keio University of Medicine, Tokyo, Japan; Kazushi Takahashi, MD, PhD, Keio University of Medicine, Tokyo, Japan; Atsuo Koto, MD, PhD, Yomiuri Land Keiyu Hospital, Tokyo, Japan; Ban Mihara, MD, PhD, Mihara Memorial Hospital, Gunma, Japan; Kyoko Gotoh, MD, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Daisuke Yasutomi, MD, PhD, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Yoko Morita, MD, PhD, National Hospital Organization Tokyo Medical Center; Taro Kadowaki, MD, PhD, Ashikaga Red Cross Hospital, Tochigi, Japan; Kazuo Isozumi, MD, PhD, Ashikaga Red Cross Hospital, Tochigi, Japan; Satoru Komatsumoto, MD, PhD, Ashikaga Red Cross Hospital, Tochigi, Japan; Kouichi Ohta, MD, PhD, Tachikawa Hospital, Tokyo, Japan; Yukito Shinohara, MD, PhD, Tachikawa Hospital, Tokyo, Japan; Kazuhiro Muramatsu, MD, PhD, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan; Masaya Kunimoto, MD, PhD, Yokohama-city Eastern Hospital, Yokohama, Japan; Jun Gotoh, MD, PhD, Saiseikai Central Hospital, Tokyo, Japan; Makoto Takagi, MD, PhD, Saiseikai Central Hospital, Tokyo, Japan; Keiji Yamaguchi, MD, PhD, Mito Red Cross Hospital, Ibaraki, Japan; Katsuyuki Obara, MD, PhD, Mito Red Cross Hospital, Ibaraki, Japan; Yutaka Tomita, MD, PhD, Tomita Hospital, Aichi, Japan; Hideki Sato, MD, Saitama Municipal Hospital, Saitama, Japan; Hidenori Hattori MD, PhD, Saitama Municipal Hospital, Saitama, Japan; Fumio Yoshikawa MD, PhD, Saitama Municipal Hospital, Saitama, Japan; Morinobu Seki, MD, Keio University of Medicine, Tokyo, Japan; Satoko Iwasawa, MD, PhD, Keio University of Medicine, Tokyo, Japan.

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Nihei, Y., Takahashi, K., Koto, A. et al. REM sleep behavior disorder in Japanese patients with Parkinson’s disease: a multicenter study using the REM sleep behavior disorder screening questionnaire. J Neurol 259, 1606–1612 (2012). https://doi.org/10.1007/s00415-011-6386-1

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