Funding agencies: This study was supported by grants from the National Institutes of Health (P50 AG16574, P50 NS72187, and R01 AG15866), Mangurian Foundation for Lewy Body Dementia Research, and Mayo Foundation for Education & Research.
Article first published online: 28 OCT 2011
Copyright © 2011 Movement Disorder Society
Volume 27, Issue 1, pages 72–78, January 2012
How to Cite
Dugger, B. N., Boeve, B. F., Murray, M. E., Parisi, J. E., Fujishiro, H., Dickson, D. W. and Ferman, T. J. (2012), Rapid eye movement sleep behavior disorder and subtypes in autopsy-confirmed dementia with Lewy bodies. Mov. Disord., 27: 72–78. doi: 10.1002/mds.24003
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 13 JAN 2012
- Article first published online: 28 OCT 2011
- Manuscript Accepted: 23 SEP 2011
- Manuscript Revised: 9 SEP 2011
- Manuscript Received: 27 JUN 2011
- Parkinson's disease;
- REM sleep behavior disorder;
- dementia with Lewy bodies;
- Lewy body disease;
- Alzheimer's disease
The purpose of this study was to determine whether dementia with Lewy bodies with and without probable rapid eye movement sleep behavior disorder differ clinically or pathologically. Patients with dementia with Lewy bodies (DLB) with probable rapid eye movement sleep behavior sleep disorder (n = 71) were compared with those without it (n = 19) on demographics, clinical variables (core features of dementia with Lewy bodies, dementia duration, rate of cognitive/motor changes), and pathologic indices (Lewy body distribution, neuritic plaque score, Braak neurofibrillary tangle stage). Individuals with probable rapid eye movement sleep behavior disorder were predominantly male (82% vs 47%) and had a shorter duration of dementia (mean, 8 vs 10 years), earlier onset of parkinsonism (mean, 2 vs 5 years), and earlier onset of visual hallucinations (mean, 3 vs 6 years). These patients also had a lower Braak neurofibrillary tangle stage (stage IV vs stage VI) and lower neuritic plaque scores (18% vs 85% frequency), but no difference in Lewy body distribution. When probable rapid eye movement sleep behavior disorder developed early (at or before dementia onset), the onset of parkinsonism and hallucinations was earlier and Braak neurofibrillary tangle stage was lower compared with those who developed the sleep disorder after dementia onset. Women with autopsy-confirmed DLB without a history of dream enactment behavior during sleep had a later onset of hallucinations and parkinsonism and a higher Braak NFT stage. Probable rapid eye movement sleep behavior disorder is associated with distinct clinical and pathologic characteristics of dementia with Lewy bodies. © 2011 Movement Disorder Society