Objective: To study the predictive factors of REM sleep behavior disorder (RBD) in military veterans with Parkinson’s disease (PD.

Background: REM sleep behavior disorder (RBD) is the most common parasomnia associated with Parkinson’s disease (PD) and other neurodegenerative disorders. Associative and / or predictive factors for RBD in military veterans with PD are not fully characterized.

Method: 124 military veterans with PD followed in our movement disorders clinic were screened for the presence of RBD using the English language version of the REM Sleep Behavior Questionnaire-Hong Kong (RBDQ-HK) [a cut point of ≥ 19 was used to define presence or absence of RBD]
Groups with and without RBD were assessed for post-traumatic stress disorder (PTSD) using PTSD-Civilian scale (PCL-C). PD disease severity and cognition were evaluated using Hoehn and Yahr rating scale (H&Y) and Unified Parkinson’s Disease Rating Scale (UPDRS), respectively.
For the PCL-C, PTSD+ was defined as described on the VA National Center for PTSD website using the combined method of having a total symptom severity score exceeding a given normative threshold (≥ 39 was used) and presence of symptoms meeting the DSM].

Results: REM sleep behavior disorder (RBD) was present in 63 (50.8%) of the subjects. In the RBD group, 25 (39.7%) subjects had PTSD as opposed to 6 (9.8%) subjects among those without RBD.
Groups with or without RBD were comparable with respect to disease severity (H&Y, median=2.0 for both), cognition (UPDRS Question 1, median=1 for both) age, gender and ethnicity.

Conclusion: Clinically probable REM sleep behavior disorder (RBD) is present in over 50% of the military veterans with Parkinson’s disease. Post traumatic stress disorder appears to coexist more commonly in PD Veterans with RBD than those who do not have RBD. Age, gender, cognition, disease severity did not differ between those with or without RBD in this sample.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-we-predict-the-development-of-rem-sleep-behavior-disorder-rbd-in-military-veterans-with-parkinsons-disease/