Objective: To assess the prevalence of REM sleep behaviour disorder (RBD) and Prodromal Parkinson’s Disease (PPD) in Essential Tremor (ET) and to characterize these sub-groups of patients.

Background: Several studies suggested the presence of non-motor symptoms in ET, including RBD. RBD is an essential criterion for PPD, suggesting a link between ET and Parkinson’s Disease (PD). Our objective was to assess the prevalence of RBD and PDD in ET and to characterize these sub-group of patients.

Method: RBD was diagnosed be questionnaire screening, followed by polysomnography. PPD risk factors and prodromic markers were assessed with a structured protocol. Patients were characterized regarding tremor features. ET patients with RBD (ET-RBD) and PPD (ET-PPD) were compared to patients without RBD (ET-nonRBD) and without PPD (ET-nonPPD), respectively. ET-RBD patients were compared with a group of isolated RBD (iRBD) regarding PPD features.

Results: We assessed a total of 64 ET patients. Five (8.3 %) and 4 (6.3%) had criteria for RBD and PPD, respectively. ET-RBD patients did not differ from ET-nonRBD except for a higher prevalence of PPD. There were no significant differences between ET-RBD and iRBD (n=12) groups. ET-PPD had a higher prevalence of positive DaT-Scans compared to ET-nonPPD. Three ET-RBD patients had PPD and 3 ET-PPD had RBD.

Conclusion: Both RBD and PPD are more frequent in ET patients than in general aged population but not related with specific tremor features. ET-RBD patients did not differ significantly from iRBD patients, a group prone to develop PD. This suggest a link between ET and PD and is in accordance with studies showing an increase incidence of lewy-body pathology and PD in ET populations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/rem-sleep-behavior-disorder-and-prodromal-parkinsons-disease-in-patients-with-essential-tremor/