Sleep medicine · 2025
Prevalence of and risk factors for probable rapid eye movement sleep behavior disorder in Chinese patients with essential tremor.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Huang Hong-Yan, Xu Fang, Zhang Dan, Luo An-Ling, Xu Yan-Ming
Аннотация
OBJECTIVES: To investigate the prevalence and risk factors for probable rapid eye movement (REM) sleep behavior disorder (pRBD) in Chinese patients with essential tremor (ET).
METHODS: In this cross-sectional study, 391 ET patients underwent assessments of sociodemographics, lifestyles, environmental exposures, medical histories, and motor/nonmotor symptoms. pRBD status was evaluated using the RBD screening questionnaire (RBDSQ). Risk factors for pRBD in ET patients were identified via multivariable logistic regression.
RESULTS: Fifty-six patients (14.3 %) met the criteria for pRBD, with a male predominance (60.7 %). Patients with pRBD were significantly older (mean age: 61.43 vs. 51.99 years) and had late tremor onset (49.34 vs. 42.21 years) than those without pRBD (both Padjusted < 0.05). They also showed higher prevalence of jaw tremor (32.1 % vs. 9.3 %), depressive symptoms (67.9 % vs. 43.3 %), antidepressant use (10.7 % vs. 1.8 %), elevated anxiety scores (Hamilton Anxiety Rating Scale: 12.38 ± 7.47 vs. 9.05 ± 6.09), and depression scores (Hamilton Depression Rating Scale-24: 11.25 ± 7.81 vs. 7.91 ± 6.20) (all Padjusted < 0.05). Multivariate analysis identified male sex (OR = 3.038, P = 0.001), older age (OR = 1.045, P < 0.001), jaw tremor (OR = 3.734, P = 0.001), at least mild depression (OR = 2.484, P = 0.006), and antidepressant use (OR = 6.069, P = 0.009) were independent predictors.
CONCLUSIONS: pRBD affects approximately 1/7 of ET patients. Identified risk factors overlap with α-synucleinopathy-associated features (male predominance, jaw tremor, depressive symptoms), suggesting ET-pRBD patients may constitute a phenoconversion-prone subgroup requiring long-term monitoring. Antidepressants known to exacerbate RBD symptoms should be prescribed judiciously in this population.
METHODS: In this cross-sectional study, 391 ET patients underwent assessments of sociodemographics, lifestyles, environmental exposures, medical histories, and motor/nonmotor symptoms. pRBD status was evaluated using the RBD screening questionnaire (RBDSQ). Risk factors for pRBD in ET patients were identified via multivariable logistic regression.
RESULTS: Fifty-six patients (14.3 %) met the criteria for pRBD, with a male predominance (60.7 %). Patients with pRBD were significantly older (mean age: 61.43 vs. 51.99 years) and had late tremor onset (49.34 vs. 42.21 years) than those without pRBD (both Padjusted < 0.05). They also showed higher prevalence of jaw tremor (32.1 % vs. 9.3 %), depressive symptoms (67.9 % vs. 43.3 %), antidepressant use (10.7 % vs. 1.8 %), elevated anxiety scores (Hamilton Anxiety Rating Scale: 12.38 ± 7.47 vs. 9.05 ± 6.09), and depression scores (Hamilton Depression Rating Scale-24: 11.25 ± 7.81 vs. 7.91 ± 6.20) (all Padjusted < 0.05). Multivariate analysis identified male sex (OR = 3.038, P = 0.001), older age (OR = 1.045, P < 0.001), jaw tremor (OR = 3.734, P = 0.001), at least mild depression (OR = 2.484, P = 0.006), and antidepressant use (OR = 6.069, P = 0.009) were independent predictors.
CONCLUSIONS: pRBD affects approximately 1/7 of ET patients. Identified risk factors overlap with α-synucleinopathy-associated features (male predominance, jaw tremor, depressive symptoms), suggesting ET-pRBD patients may constitute a phenoconversion-prone subgroup requiring long-term monitoring. Antidepressants known to exacerbate RBD symptoms should be prescribed judiciously in this population.