Journal ArticleDOI
Neurodegenerative disease status and post-mortem pathology in idiopathic rapid-eye-movement sleep behaviour disorder: an observational cohort study
Alex Iranzo,Eduard Tolosa,Ellen Gelpi,José Luis Molinuevo,Francesc Valldeoriola,Mónica Serradell,Raquel Sánchez-Valle,Isabel Vilaseca,Francisco Lomeña,Dolores Vilas,Albert Lladó,Carles Gaig,Joan Santamaria +12 more
TLDR
These findings indicate that in most patients diagnosed with IRBD this parasomnia represents the prodromal phase of a Lewy body disorder, and IRBD is a candidate for the study of early events and progression of this prodromic phase, and to test disease-modifying strategies to slow or stop the neurodegenerative process.Abstract:
Summary Background We postulated that idiopathic rapid-eye-movement (REM) sleep behaviour disorder (IRBD) represents the prodromal phase of a Lewy body disorder and that, with sufficient follow-up, most cases would eventually be diagnosed with a clinical defined Lewy body disorder, such as Parkinson's disease (PD) or dementia with Lewy bodies (DLB). Methods Patients from an IRBD cohort recruited between 1991 and 2003, and previously assessed in 2005, were followed up during an additional period of 7 years. In this original cohort, we sought to identify the nature and frequency of emerging defined neurodegenerative syndromes diagnosed by standard clinical criteria. We estimated rates of survival free from defined neurodegenerative disease by means of the Kaplan-Meier method. We further characterised individuals who remained diagnosed as having only IRBD, through dopamine transporter (DAT) imaging, transcranial sonography (TCS), and olfactory testing. We did a neuropathological assessment in three patients who died during follow-up and who had the antemortem diagnosis of PD or DLB. Findings Of the 44 participants from the original cohort, 36 (82%) had developed a defined neurodegenerative syndrome by the 2012 assessment (16 patients were diagnosed with PD, 14 with DLB, one with multiple system atrophy, and five with mild cognitive impairment). The rates of neurological-disease-free survival from time of IRBD diagnosis were 65·2% (95% CI 50·9 to 79·5) at 5 years, 26·6% (12·7 to 40·5) at 10 years, and 7·5% (−1·9 to 16·9) at 14 years. Of the four remaining neurological-disease-free individuals who underwent neuroimaging and olfactory tests, all four had decreased striatal DAT uptake, one had substantia nigra hyperechogenicity on TCS, and two had impaired olfaction. In three patients, the antemortem diagnoses of PD and DLB were confirmed by neuropathological examination showing widespread Lewy bodies in the brain, and α-synuclein aggregates in the peripheral autonomic nervous system in one case. In these three patients, neuronal loss and Lewy pathology (α-synuclein-containing Lewy bodies and Lewy neurites) were found in the brainstem nuclei that regulate REM sleep atonia. Interpretation Most IRBD individuals from our cohort developed a Lewy body disorder with time. Patients who remained disease-free at follow-up showed markers of increased short-term risk for developing PD and DLB in IRBD, such as decreased striatal DAT binding. Our findings indicate that in most patients diagnosed with IRBD this parasomnia represents the prodromal phase of a Lewy body disorder. IRBD is a candidate for the study of early events and progression of this prodromal phase, and to test disease-modifying strategies to slow or stop the neurodegenerative process. Funding None.read more
Citations
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Journal ArticleDOI
MDS research criteria for prodromal Parkinson's disease
Daniela Berg,Ronald B. Postuma,Charles H. Adler,Bastiaan R. Bloem,Piu Chan,Bruno Dubois,Thomas Gasser,Christopher G. Goetz,Glenda M. Halliday,Lawrence Joseph,Anthony E. Lang,Inga Liepelt-Scarfone,Irene Litvan,Kenneth Marek,Jose A. Obeso,Wolfgang H. Oertel,C. Warren Olanow,Werner Poewe,Matthew B. Stern,Günther Deuschl +19 more
TL;DR: These criteria represent a first step in the formal delineation of early stages of PD and will require constant updating as more information becomes available.
Journal ArticleDOI
Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients.
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 Santamaria +11 more
TL;DR: 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.
Journal ArticleDOI
A novel non-rapid-eye movement and rapid-eye-movement parasomnia with sleep breathing disorder associated with antibodies to IgLON5: a case series, characterisation of the antigen, and post-mortem study
Lidia Sabater,Carles Gaig,Ellen Gelpi,Luis Bataller,Jan Lewerenz,Estefanía Torres-Vega,Angeles Contreras,Bruno Giometto,Yaroslau Compta,Cristina Embid,Isabel Vilaseca,Alex Iranzo,Joan Santamaria,Josep Dalmau,Josep Dalmau,Josep Dalmau,Francesc Graus +16 more
TL;DR: The features of a novel neurological syndrome associated with prominent sleep dysfunction and antibodies to a neuronal antigen are described and pathological features suggesting a tauopathy are described.
Journal ArticleDOI
Alpha‐synuclein RT‐QuIC in the CSF of patients with alpha‐synucleinopathies
Graham Fairfoul,Lynne McGuire,Suvankar Pal,James W. Ironside,Juliane Neumann,S Christie,Catherine Joachim,Margaret M. Esiri,Samuel Evetts,Michal Rolinski,Fahd Baig,Claudio Ruffmann,Richard Wade-Martins,Michele T.M. Hu,Laura Parkkinen,Alison Green +15 more
TL;DR: The results suggest that RT‐QuiC analysis of cerebrospinal fluid is potentially useful for the early clinical assessment of patients with alpha‐synucleinopathies.
Journal ArticleDOI
Parkinson risk in idiopathic REM sleep behavior disorder: Preparing for neuroprotective trials
Ronald B. Postuma,Jean-François Gagnon,Josie Anne Bertrand,Daphné Génier Marchand,Jacques Montplaisir +4 more
TL;DR: Using stratification with simply assessed markers, it is now not only possible, but practical to include patients with RBD in neuroprotective trials against Parkinson disease, multiple system atrophy, and dementia with Lewy bodies.
References
More filters
Journal ArticleDOI
Diagnostic and Statistical Manual of Mental Disorders
Vijay A. Mittal,Elaine F. Walker +1 more
TL;DR: An issue concerning the criteria for tic disorders is highlighted, and how this might affect classification of dyskinesias in psychotic spectrum disorders.
Book ChapterDOI
Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
Journal ArticleDOI
Neuropathological stageing of Alzheimer-related changes.
Heiko Braak,Eva Braak +1 more
TL;DR: The investigation showed that recognition of the six stages required qualitative evaluation of only a few key preparations, permitting the differentiation of six stages.
Journal ArticleDOI
Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.
TL;DR: The pathological findings in 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic Parkinson's disease are reported, and these observations call into question current concepts of Parkinson's Disease as a single distinct morbid entity.