Risk Factor Profile in Parkinson’s Disease Subtype with REM Sleep Behavior Disorder

Article type: Research Article

Authors: Jacobs, Marie L.^a | Dauvilliers, Yves^b | St. Louis, Erik K.^c | McCarter, Stuart J.^c | Romenets, Silvia Rios^a | Pelletier, Amélie^{a; d} | Cherif, Mahmoud^e | Gagnon, Jean-François^{d; f} | Postuma, Ronald B.^{a; d; *}

Affiliations: [a] Department of Neurology, McGill University, Montreal General Hospital, Montréal, Canada | [b] Reference Center for Narcolepsy, Sleep Unit, Department of Neurology, Hôpital Gui de Chauliac, INSERM U1061, Montpellier, F-34093 Cedex 5 France | [c] Mayo Center for Sleep Medicine, Departments of Medicine and Neurology, Mayo Clinic and Foundation, Rochester, MN, USA | [d] Centre d’Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada | [e] Department of Neurology, Hôpital Gui de Chauliac, INSERM U1061, Montpellier, F-34093 Cedex 5 France | [f] Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada

Correspondence: [*] Correspondence to: Dr. Ronald B. Postuma, Department of Neurology, L7-305 Montreal General Hospital, 1650 Cedar Avenue, Montréal, Québec, H3G1A4 Canada. E-mail: ron.postuma@mcgill.ca.

Abstract: Background: Numerous large-scale studies have found diverse risk factors for Parkinson’s disease (PD), including caffeine non-use, non-smoking, head injury, pesticide exposure, and family history. These studies assessed risk factors for PD overall; however, PD is a heterogeneous condition. One of the strongest identifiers of prognosis and disease subtype is the co-occurrence of rapid eye movement sleep behavior disorder (RBD). In previous studies, idiopathic RBD was associated with a different risk factor profile from PD and dementia with Lewy bodies, suggesting that the PD-RBD subtype may also have a different risk factor profile. Objective: To define risk factors for PD in patients with or without associated RBD. Methods: In a questionnaire, we assessed risk factors for PD, including demographic, medical, environmental, and lifestyle variables of 189 PD patients with or without associated polysomnography-confirmed RBD. The risk profile of patients with vs. without RBD was assessed with logistic regression, adjusting for age, sex, and disease duration. Results: PD-RBD patients were more likely to have been a welder (OR = 3.11 (1.05–9.223), and to have been regular smokers (OR = 1.96 (1.04–3.68)). There were no differences in use of caffeine or alcohol, other occupations, pesticide exposure, rural living, or well water use. Patients with RBD had a higher prevalence of the combined family history of both dementia and parkinsonism (13.3% vs. 5.5% , OR = 3.28 (1.07–10.0). Conclusion: The RBD-specific subtype of PD may also have a different risk factor profile.

Keywords: Parkinson’s disease, REM sleep behavior disorder, risk factors

DOI: 10.3233/JPD-150725

Journal: Journal of Parkinson's Disease, vol. 6, no. 1, pp. 231-237, 2016