REM sleep behavior disorder and neuropathology in Parkinson's disease

Ronald B. Postuma, Charles H. Adler, Brittany N. Dugger, Joseph G. Hentz, Holly A. Shill, Erika Driver-Dunckley, Marwan N. Sabbagh, Sandra A. Jacobson, Christine M. Belden, Lucia I. Sue, Geidy Serrano, Thomas G. Beach

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Introduction: Rapid eye movement (REM) sleep behavior disorder (RBD) in Parkinson's disease (PD) is associated with differences in clinical phenotype, including dementia, autonomic loss, and gait dysfunction. The pathological basis for this remains unclear. Methods: Parkinson's disease subjects in a longitudinal clinicopathologic study were screened for probable RBD with the Mayo Sleep Questionnaire. After death, semiquantitative analyses were conducted for synuclein, amyloid, neurofibrillary tangles, and cerebrovascular lesions. Results: Forty cases had probable RBD (PD+RBD), and 41 did not (PD-RBD). Despite similar age at death (∼80 y) and disease duration (∼14.5 y), PD+RBD had increased synuclein deposition in all regions examined, with nine of 10 regions significantly different. The Lewy body 10-region total score (scale = 0-40) was 29.5 in PD+RBD versus 24.5 in PD-RBD (Cohen-d effect size = 0.79, P = 0.002). Cerebrovascular lesion burden was slightly higher in PD-RBD. Conclusions: Although overlap occurs between groups, PD patients with probable RBD may have greater density and range of synuclein pathology on autopsy.

Original languageEnglish (US)
Pages (from-to)1413-1417
Number of pages5
JournalMovement Disorders
Issue number10
StatePublished - Sep 1 2015


  • Diagnosis
  • Parkinson's disease
  • Pathology
  • REM sleep behavior disorder

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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