Relationship between rapid eye movement sleep behavior disorder and autonomic dysfunction in patients with Parkinson's disease
Objective This study was aimed at exploring the relationship between rapid eye movement sleep behavior disorder(RBD)and autonomic dysfunction in patients with Parkinson's disease,to provide a reference for clinical diagnosis and treatment.Methods A total of 1 029 patients with Parkinson's disease in the Parkinson's Progression Markers Initia-tive(PPMI)database from 2011 to 2023 were selected for this research.General information,RBD(evaluated with the RBD screening questionnaire),and autonomic symptoms(evaluated with the autonomic symptom questionnaire)were analyzed.Logistic regression analysis was conducted with RBD as the dependent variable and autonomic symptoms as the independent variable,to explore their relationship.Results The 1 029 participants comprised 642 men(62.4％)and 387 women(37.6％);777 patients(75.5％)were 56 years of age or older,and the education levels ranged from 13 to 23 years in 836 patients(81.2％).Most participants were of white people(958 patients;93.0％).Hoehn-Yahr stages 0,1,and 2 were observed in 1 005 patients(97.7％);274 patients(26.63％)had RBD;and 1 006 patients(97.8％)had autonomic nervous dysfunction.After adjustment for age,gender,education level,Hoehn-Yahr stage,family history,and disease dura-tion,logistic regression analysis indicated that patients with gastrointestinal system dysfunction(OR=1.191,P＜0.001),cardiovascular system dysfunction(OR=1.283,P=0.003),and sexual dysfunction(OR=1.099,P=0.043)were relative-ly more likely to have RBD.As the number of coexisting domains of autonomic dysfunction increased,the effects on RBD increased accordingly.When the number of coexisting domains of autonomic dysfunction reached four or more,the effect was statistically significant(OR=10.177,P=0.026;OR=13.422,P=0.012;OR=17.695,P=0.006).Conclusion RBD is associated with autonomic dysfunction in patients with Parkinson's disease,and the effects on RBD increase with the number of auto-nomic dysfunction items present.
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