Abstract Details

Title Suicidal Ideation is Associated with Greater Autonomic and Motor Dysfunction in Patients with REM Sleep Behavior Disorder

Topic Sleep

Presentation(s) S6 - Sleep (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Background RBD is characterized by loss of REM sleep atonia leading to dream enactment behavior. RBD is a known prodromal syndrome of alpha-synuclein pathology including Parkinson’s disease (PD) and Lewy body dementia (LBD). Depression is a common prodromal symptom of PD/LBD and death by suicide is greater among individuals with PD/LBD. However, it is not known what comorbidities predict suicidal ideation among individuals with RBD.

Objective We aim to assess markers of neurodegenerative disease burden in patients with REM sleep behavior disorder (RBD) who endorsed suicidal ideation in the North American Prodromal Synucleinopathy (NAPS) consortium registry.

Design/Methods

This is a longitudinal study that measured neurological function over time via scores on the Montreal Cognitive Assessment (cognition), SCOPA-AUT, (autonomic) and Motor UPDRS, of RBD patients who endorsed suicidal ideation on the PHQ-9 questionnaire compared to those who did not. We utilized a linear mixed effects model, adjusting for age, sex, impulsivity, and dopaminergics.

Results Those with suicidal ideation had a significantly higher total SCOPA-AUT score, on average 2.968 points higher (SE = 0.658, p = 7.43x10-6), and a significantly higher Motor UPDRS score, on average 1.668 points higher (SE = 0.826, p = 0.044), compared to those without suicidal ideation. Carbidopa/levodopa use was associated with higher SCOPA-AUT scores. Age, current carbidopa/levodopa use, and impulsivity had significant effects on Motor UPDRS scores. There was not a significant association between suicidality and total MoCA score.

Conclusions Individuals with RBD who endorsed suicidal ideation had a greater burden of autonomic and motor symptoms compared to those who did not endorse suicidal ideation. Clinical studies are need to determine whether targeted interventions can decrease mortality among RBD patients at high risk for death by suicide.

Authors/Disclosures
Neha V. Reddy PRESENTER	Miss Reddy has nothing to disclose.
Meaghan Berns, MD	Dr. Berns has nothing to disclose.
Erjia Cui	Dr. Cui has nothing to disclose.
Michael J. Howell, MD, FAAN	Dr. Howell has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for GEM Health. Dr. Howell has stock in Sleep Performance Institute. The institution of Dr. Howell has received research support from National Institutes of Health. Dr. Howell has received publishing royalties from a publication relating to health care.

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