Abstract Details

Title Autonomic Dysfunction in Idiopathic REM Sleep Behavior Disorder

Topic Autonomic Disorders

Presentation(s) S37 - (-)

Poster/Presentation
Number 003

Background There was no prior report that carefully examines autonomic dysfunction in patients with idiopathic RBD using standardized autonomic function tests.

Objective

Design/Methods During study period, we prospectively identified patients with idiopathic RBD. The diagnosis of RBD was made by using history with overnight polysomnography according to standard International Classification of Sleep Disorders-II criteria (2005). All patients had a baseline neurologic examination to exclude the secondary RBD with neurodegenerative disease. We also excluded patients with other neurologic, psychiatric or other medical conditions that potentially cause autonomic dysfunction. Symptoms of autonomic dysfunction were assessed with the survey of autonomic symptoms. Standardized autonomic function tests were performed including tilt table, Valsalva maneuver, heart rate response to deep breathing and quantitative sudomotor axon reflex test. The composite Autonomic Severity Score (CASS) was used to assess the severity and distribution of autonomic dysfunction. Plasma norepinephrine level during supine was also measured.

Results Fifteen patients (5 men and 10 women, mean age; 66.3 years) with idiopathic RBD were included in our study. All patients except one (93%) showed mild (3 or less on CASS) to moderate (4 to 6 on CASS) autonomic dysfunction. Deficits were predominantly adrenergic (11/15; 73%) and cardiovagal (10/15; 67%). Patients with idiopathic RBD who had low norepinephrine level at supine position tend to have an increased tonic chin EMG activity during REM sleep at baseline (p=0.036). All patients had autonomic symptoms, in which orthostatic dizziness (8/15; 53%) and bladder dysfunction (7/15; 47%) were common complaints.

Conclusions Our result suggests that idiopathic RBD alone can produce autonomic dysfunctions with mild to moderate degree. The severity of loss of REM atonia predicting the development of Parkinson disease negatively correlates with circulating norepinephrine level presenting sympathetic outflow.

Authors/Disclosures
PRESENTER	No disclosure on file
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has stock in NeuroRx.
	No disclosure on file

��ɫ��

��ɫ��