Subtle gait changes in patients with REM sleep behavior disorder

Eric M. Mcdade, Brendon P. Boot, Teresa J H Christianson, V. Shane Pankratz, Bradley F Boeve, Tanis Jill Ferman, Kevin Bieniek, John H. Hollman, Rosebud O Roberts, Michelle M Mielke, David S Knopman, Ronald Carl Petersen

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Many people with rapid eye movement (REM) sleep behavior disorder (RBD) have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. Because gait disorders are common in the synucleinopathies, early abnormalities in gait in those with RBD could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment. We identified 42 probable RBD subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence, and stride dynamics with an automated gait analysis system. Cases and controls were similar in age (79.9±4.7 and 80.1±4.7, P=0.74), Unified Parkinson's Disease Rating Scale Part III (UPDRS) score (3.3±5.5 and 1.9±4.1, P=0.21) and Mini-Mental State Examination scores (27.2±1.9 and 27.7±1.6, P=0.10). A diagnosis of probable RBD was associated with decreased velocity (-7.9 cm/s; 95% confidence interval [CI], -13.8 to -2.0; P<0.01), cadence (-4.4 steps/min; 95% CI, -7.6 to -1.3; P<0.01), significantly increased double limb support variability (30%; 95% CI, 6-60; P=0.01), and greater stride time variability (29%; 95% CI, 2-63; P=0.03) and swing time variability (46%; 95% CI, 15-84; P<0.01). Probable RBD is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable RBD supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.

Original languageEnglish (US)
Pages (from-to)1847-1853
Number of pages7
JournalMovement Disorders
Volume28
Issue number13
DOIs
StatePublished - Nov 2013

Fingerprint

REM Sleep Behavior Disorder
Gait
Confidence Intervals
Parkinsonian Disorders
Synucleins
Lewy Body Disease
Parkinson Disease
Sleep
Extremities

Keywords

  • Gait
  • Gait variability
  • REM sleep behavior disorder

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Subtle gait changes in patients with REM sleep behavior disorder. / Mcdade, Eric M.; Boot, Brendon P.; Christianson, Teresa J H; Pankratz, V. Shane; Boeve, Bradley F; Ferman, Tanis Jill; Bieniek, Kevin; Hollman, John H.; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Petersen, Ronald Carl.

In: Movement Disorders, Vol. 28, No. 13, 11.2013, p. 1847-1853.

Research output: Contribution to journalArticle

Mcdade, EM, Boot, BP, Christianson, TJH, Pankratz, VS, Boeve, BF, Ferman, TJ, Bieniek, K, Hollman, JH, Roberts, RO, Mielke, MM, Knopman, DS & Petersen, RC 2013, 'Subtle gait changes in patients with REM sleep behavior disorder', Movement Disorders, vol. 28, no. 13, pp. 1847-1853. https://doi.org/10.1002/mds.25653
Mcdade, Eric M. ; Boot, Brendon P. ; Christianson, Teresa J H ; Pankratz, V. Shane ; Boeve, Bradley F ; Ferman, Tanis Jill ; Bieniek, Kevin ; Hollman, John H. ; Roberts, Rosebud O ; Mielke, Michelle M ; Knopman, David S ; Petersen, Ronald Carl. / Subtle gait changes in patients with REM sleep behavior disorder. In: Movement Disorders. 2013 ; Vol. 28, No. 13. pp. 1847-1853.
@article{1a93b8738c8149349989faab519d6d27,
title = "Subtle gait changes in patients with REM sleep behavior disorder",
abstract = "Many people with rapid eye movement (REM) sleep behavior disorder (RBD) have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. Because gait disorders are common in the synucleinopathies, early abnormalities in gait in those with RBD could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment. We identified 42 probable RBD subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence, and stride dynamics with an automated gait analysis system. Cases and controls were similar in age (79.9±4.7 and 80.1±4.7, P=0.74), Unified Parkinson's Disease Rating Scale Part III (UPDRS) score (3.3±5.5 and 1.9±4.1, P=0.21) and Mini-Mental State Examination scores (27.2±1.9 and 27.7±1.6, P=0.10). A diagnosis of probable RBD was associated with decreased velocity (-7.9 cm/s; 95{\%} confidence interval [CI], -13.8 to -2.0; P<0.01), cadence (-4.4 steps/min; 95{\%} CI, -7.6 to -1.3; P<0.01), significantly increased double limb support variability (30{\%}; 95{\%} CI, 6-60; P=0.01), and greater stride time variability (29{\%}; 95{\%} CI, 2-63; P=0.03) and swing time variability (46{\%}; 95{\%} CI, 15-84; P<0.01). Probable RBD is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable RBD supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.",
keywords = "Gait, Gait variability, REM sleep behavior disorder",
author = "Mcdade, {Eric M.} and Boot, {Brendon P.} and Christianson, {Teresa J H} and Pankratz, {V. Shane} and Boeve, {Bradley F} and Ferman, {Tanis Jill} and Kevin Bieniek and Hollman, {John H.} and Roberts, {Rosebud O} and Mielke, {Michelle M} and Knopman, {David S} and Petersen, {Ronald Carl}",
year = "2013",
month = "11",
doi = "10.1002/mds.25653",
language = "English (US)",
volume = "28",
pages = "1847--1853",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley and Sons Inc.",
number = "13",

}

TY - JOUR

T1 - Subtle gait changes in patients with REM sleep behavior disorder

AU - Mcdade, Eric M.

AU - Boot, Brendon P.

AU - Christianson, Teresa J H

AU - Pankratz, V. Shane

AU - Boeve, Bradley F

AU - Ferman, Tanis Jill

AU - Bieniek, Kevin

AU - Hollman, John H.

AU - Roberts, Rosebud O

AU - Mielke, Michelle M

AU - Knopman, David S

AU - Petersen, Ronald Carl

PY - 2013/11

Y1 - 2013/11

N2 - Many people with rapid eye movement (REM) sleep behavior disorder (RBD) have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. Because gait disorders are common in the synucleinopathies, early abnormalities in gait in those with RBD could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment. We identified 42 probable RBD subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence, and stride dynamics with an automated gait analysis system. Cases and controls were similar in age (79.9±4.7 and 80.1±4.7, P=0.74), Unified Parkinson's Disease Rating Scale Part III (UPDRS) score (3.3±5.5 and 1.9±4.1, P=0.21) and Mini-Mental State Examination scores (27.2±1.9 and 27.7±1.6, P=0.10). A diagnosis of probable RBD was associated with decreased velocity (-7.9 cm/s; 95% confidence interval [CI], -13.8 to -2.0; P<0.01), cadence (-4.4 steps/min; 95% CI, -7.6 to -1.3; P<0.01), significantly increased double limb support variability (30%; 95% CI, 6-60; P=0.01), and greater stride time variability (29%; 95% CI, 2-63; P=0.03) and swing time variability (46%; 95% CI, 15-84; P<0.01). Probable RBD is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable RBD supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.

AB - Many people with rapid eye movement (REM) sleep behavior disorder (RBD) have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. Because gait disorders are common in the synucleinopathies, early abnormalities in gait in those with RBD could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment. We identified 42 probable RBD subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence, and stride dynamics with an automated gait analysis system. Cases and controls were similar in age (79.9±4.7 and 80.1±4.7, P=0.74), Unified Parkinson's Disease Rating Scale Part III (UPDRS) score (3.3±5.5 and 1.9±4.1, P=0.21) and Mini-Mental State Examination scores (27.2±1.9 and 27.7±1.6, P=0.10). A diagnosis of probable RBD was associated with decreased velocity (-7.9 cm/s; 95% confidence interval [CI], -13.8 to -2.0; P<0.01), cadence (-4.4 steps/min; 95% CI, -7.6 to -1.3; P<0.01), significantly increased double limb support variability (30%; 95% CI, 6-60; P=0.01), and greater stride time variability (29%; 95% CI, 2-63; P=0.03) and swing time variability (46%; 95% CI, 15-84; P<0.01). Probable RBD is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable RBD supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.

KW - Gait

KW - Gait variability

KW - REM sleep behavior disorder

UR - http://www.scopus.com/inward/record.url?scp=84887619877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887619877&partnerID=8YFLogxK

U2 - 10.1002/mds.25653

DO - 10.1002/mds.25653

M3 - Article

C2 - 24130124

AN - SCOPUS:84887619877

VL - 28

SP - 1847

EP - 1853

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

IS - 13

ER -