Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.

<h4>Objective</h4>To estimate the risk for developing a defined neurodegenerative syndrome in a large cohort of idiopathic REM sleep behavior disorder (IRBD) patients with long follow-up.<h4>Methods</h4>Using the Kaplan-Meier method, we estimated the disease-free survival rat...

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Autores principales: Alex Iranzo, Ana Fernández-Arcos, Eduard Tolosa, Mónica Serradell, José Luis Molinuevo, Francesc Valldeoriola, Ellen Gelpi, Isabel Vilaseca, Raquel Sánchez-Valle, Albert Lladó, Carles Gaig, Joan Santamaría
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:e47d1941e5574fcfa1e6134c633b0b8c2021-11-18T08:30:52ZNeurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.1932-620310.1371/journal.pone.0089741https://doaj.org/article/e47d1941e5574fcfa1e6134c633b0b8c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24587002/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To estimate the risk for developing a defined neurodegenerative syndrome in a large cohort of idiopathic REM sleep behavior disorder (IRBD) patients with long follow-up.<h4>Methods</h4>Using the Kaplan-Meier method, we estimated the disease-free survival rate from defined neurodegenerative syndromes in all the consecutive IRBD patients diagnosed and followed-up in our tertiary referal sleep center between November 1991 and July 2013.<h4>Results</h4>The cohort comprises 174 patients with a median age at diagnosis of IRBD of 69 years and a median follow-up of four years. The risk of a defined neurodegenerative syndrome from the time of IRBD diagnosis was 33.1% at five years, 75.7% at ten years, and 90.9% at 14 years. The median conversion time was 7.5 years. Emerging diagnoses (37.4%) were dementia with Lewy bodies (DLB) in 29 subjects, Parkinson disease (PD) in 22, multiple system atrophy (MSA) in two, and mild cognitive impairment (MCI) in 12. In six cases, in whom postmortem was performed, neuropathological examination disclosed neuronal loss and widespread Lewy-type pathology in the brain in each case.<h4>Conclusions</h4>In a large IRBD cohort diagnosed in a tertiary referal sleep center, prolonged follow-up indicated that the majority of patients are eventually diagnosed with the synucleinopathies PD, DLB and less frequently MSA. IRBD represented the prodromal period of these conditions. Our findings in IRBD have important implications in clinical practice, in the investigation of the early pathological events occurring in the synucleinopathies, and for the design of interventions with potential disease-modifying agents.Alex IranzoAna Fernández-ArcosEduard TolosaMónica SerradellJosé Luis MolinuevoFrancesc ValldeoriolaEllen GelpiIsabel VilasecaRaquel Sánchez-ValleAlbert LladóCarles GaigJoan SantamaríaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e89741 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Alex Iranzo
Ana Fernández-Arcos
Eduard Tolosa
Mónica Serradell
José Luis Molinuevo
Francesc Valldeoriola
Ellen Gelpi
Isabel Vilaseca
Raquel Sánchez-Valle
Albert Lladó
Carles Gaig
Joan Santamaría
Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
description <h4>Objective</h4>To estimate the risk for developing a defined neurodegenerative syndrome in a large cohort of idiopathic REM sleep behavior disorder (IRBD) patients with long follow-up.<h4>Methods</h4>Using the Kaplan-Meier method, we estimated the disease-free survival rate from defined neurodegenerative syndromes in all the consecutive IRBD patients diagnosed and followed-up in our tertiary referal sleep center between November 1991 and July 2013.<h4>Results</h4>The cohort comprises 174 patients with a median age at diagnosis of IRBD of 69 years and a median follow-up of four years. The risk of a defined neurodegenerative syndrome from the time of IRBD diagnosis was 33.1% at five years, 75.7% at ten years, and 90.9% at 14 years. The median conversion time was 7.5 years. Emerging diagnoses (37.4%) were dementia with Lewy bodies (DLB) in 29 subjects, Parkinson disease (PD) in 22, multiple system atrophy (MSA) in two, and mild cognitive impairment (MCI) in 12. In six cases, in whom postmortem was performed, neuropathological examination disclosed neuronal loss and widespread Lewy-type pathology in the brain in each case.<h4>Conclusions</h4>In a large IRBD cohort diagnosed in a tertiary referal sleep center, prolonged follow-up indicated that the majority of patients are eventually diagnosed with the synucleinopathies PD, DLB and less frequently MSA. IRBD represented the prodromal period of these conditions. Our findings in IRBD have important implications in clinical practice, in the investigation of the early pathological events occurring in the synucleinopathies, and for the design of interventions with potential disease-modifying agents.
format article
author Alex Iranzo
Ana Fernández-Arcos
Eduard Tolosa
Mónica Serradell
José Luis Molinuevo
Francesc Valldeoriola
Ellen Gelpi
Isabel Vilaseca
Raquel Sánchez-Valle
Albert Lladó
Carles Gaig
Joan Santamaría
author_facet Alex Iranzo
Ana Fernández-Arcos
Eduard Tolosa
Mónica Serradell
José Luis Molinuevo
Francesc Valldeoriola
Ellen Gelpi
Isabel Vilaseca
Raquel Sánchez-Valle
Albert Lladó
Carles Gaig
Joan Santamaría
author_sort Alex Iranzo
title Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
title_short Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
title_full Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
title_fullStr Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
title_full_unstemmed Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
title_sort neurodegenerative disorder risk in idiopathic rem sleep behavior disorder: study in 174 patients.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/e47d1941e5574fcfa1e6134c633b0b8c
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