Movement disorders clinical practice · 2025
Being Prodromal: Current Criteria in the Context of Isolated REM Sleep Behavior Disorder.
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Ophey Anja, Röttgen Sinah, Reichrath Julia, Kalbe Elke, Fink Gereon R, Sommerauer Michael
Аннотация
BACKGROUND: Isolated REM sleep behavior disorder (iRBD) indicates an early α-synucleinopathy with approximately 90% of individuals pheno-converting to Parkinson's disease (PD), dementia with Lewy bodies (DLB), or multiple system atrophy (MSA). Recently, prodromal disease definitions (pPD, pDLB, pMSA) have been introduced.
OBJECTIVE: To investigate the overlap of prodromal definitions in an established iRBD cohort.
METHODS: We applied the current diagnostic criteria for pPD, pDLB, and pMSA to N = 55 individuals from the local iRBD cohort.
RESULTS: All except two individuals fulfilled at least one of the prodromal disease definitions; most individuals were classified as pPD (94.5%). 56% of the individuals fulfilled more than one definition: 32.7% pMSA&pPD, 10.9% pDLB&pPD, and 12.7% all three (pPD&pDLB&pMSA). The cognitive screening [(pPD = pMSA) > pDLB], motor symptoms [pPD < (pDLB = pMSA)], and olfactory testing [(pPD = pDLB) < pMSA] significantly differed between groups.
CONCLUSIONS: The observed overlap leads to challenges in patient counseling and risk disclosure. Better discrimination will facilitate research in early α-synucleinopathy phases.
OBJECTIVE: To investigate the overlap of prodromal definitions in an established iRBD cohort.
METHODS: We applied the current diagnostic criteria for pPD, pDLB, and pMSA to N = 55 individuals from the local iRBD cohort.
RESULTS: All except two individuals fulfilled at least one of the prodromal disease definitions; most individuals were classified as pPD (94.5%). 56% of the individuals fulfilled more than one definition: 32.7% pMSA&pPD, 10.9% pDLB&pPD, and 12.7% all three (pPD&pDLB&pMSA). The cognitive screening [(pPD = pMSA) > pDLB], motor symptoms [pPD < (pDLB = pMSA)], and olfactory testing [(pPD = pDLB) < pMSA] significantly differed between groups.
CONCLUSIONS: The observed overlap leads to challenges in patient counseling and risk disclosure. Better discrimination will facilitate research in early α-synucleinopathy phases.