Abstract Details

Title Cognitive Determinants in Isolated REM Sleep Behavior Disorder: a Cross-sectional and Longitudinal Approach

Topic Sleep

Presentation(s) S3 - Sleep Medicine: Highlights 2020 (2:24 PM-2:36 PM)

Poster/Presentation
Number 008

Background iRBD has been related to poorer cognitive performances and to higher frequency of mild cognitive impairment (MCI). Impairment in executive functions and attention, verbal episodic memory, and visuospatial abilities has been described towards the development of a full-blown dementia (with Lewy Bodies).

Objective To assess cognitive functions in a group of patients with isolated REM sleep behavior disorder (iRBD) and their longitudinal prognostic progression.

Design/Methods We enrolled consecutive videopolisomnography-confirmed iRBD (iRBDs) patients referring to our center and age and sex matched controls (HC) in whom RBD was videopolisomnographically excluded. Each subject underwent an evaluation of cognitive performances through validated neuropsychological tests. Additionally, participants underwent a neurological examination, autonomic and odor tests and filled questionnaires for non-motor symptoms. Procedures were performed at baseline (T0), and annually (T1: 12 months, T3: 36 months).

Results We recruited 29 patients and 26 controls, at T3 5 patients had converted to overt disease (2 PD, 2 prodromal DLB, 1 MSA). At baseline, 17 patients were cognitively normal (CN), 5 had 1 test impaired (CI) and 7 fulfilled the criteria for MCI. iRBDs showed poorer performance than HC in global cognition (FR BMDB - iRBD:1,88±0,64, HC:2,39±0,70; p:0,007), short term verbal (RAVLT IR - iRBD:37,88±7,70, HC:44,00±8,66; p:0,008) and immediate visual memory (IVM - iRBD:19,43±2,28, HC:20,66±1,75; p:0,03), visuo-constructional abilities (SCD - iRBD:10,52±1,62; HC:11,36±1,18; p:0,03) and executive functions (SVAT - iRBD:16,63±2,72, HC:17,93±1,82; p:0,04). Odor and autonomic tests and sleep features CN were not different in CN, CI and MCI patients. At T1 evaluation (14 patients) iRBDs worsened in IVM (T0:19,02±2,11, T1:18,39±1,47; p:0,04) and attention (Stroop Time - T0:20,42±10,39, T1:21,33±11,92, p:0,02). iRBDs became also more apathetic than controls (Apathy scale - iRBD:35,94±6,85, HC:30,07±6,46, p:0,02).

Conclusions Our results suggest a continuum from HC to CI iRBDs, with sparing of language and impairment of visuospatial function. During progression verbal memory and executive functions get worse in the MCI stage, eventually deteriorating toward dementia.

Authors/Disclosures
Luca Baldelli, MD (Department of Biomedical and NeuroMotor Sciences (DiBiNeM) University of Bologna) PRESENTER	No disclosure on file
	No disclosure on file
Giovanna Calandra-Buonaura	No disclosure on file
Pietro Guaraldi, MD, PhD (IRCCS Istituto Delle Scienze Neurologiche Di Bologna)	No disclosure on file
Pietro Cortelli, MD, FAAN	Dr. Cortelli has nothing to disclose.
Federica Provini	No disclosure on file

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