Affiliations: [a] Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| [b] Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| [c] Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| [d] Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| [e] Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| [f] Memory and Behavioral Neurology Division, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
Correspondence:
[*]
Correspondence to: Amir Ashraf-ganjouei, MD, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran 141775533, Iran. E-mail: a-ganjouei@student.tums.ac.ir.
Abstract: Background:REM behavior disorder (RBD) can occur in the context of neurodegenerative alpha-synucleinopathies, such as Parkinson’s disease (PD). PD patients with RBD (PD-pRBD) represent more severe symptoms and signs compared with those without RBD (PD-nRBD). On another note, autonomic dysfunction in PD patients is categorized as one of the most prominent non-motor symptoms and has been lately the field of interest in research. Objective:In the current study, we longitudinally studied autonomic dysfunction in PD-pRBD and PD-nRBD groups. Method:This study was conducted on 420 drug-naïve PD patients selected from the Parkinson’s Progression Markers Initiative database. The RBD Screening Questionnaire was used to define the presence of probable RBD. SCOPA-AUT was used to assess autonomic dysfunction. Additionally, dopamine transporter deficits on [123I] FP-CIT SPECT imaging was performed for all of the patients. Results:Out of 420 PD patients, 158 individuals (37.6%) were considered to have probable RBD (PD-pRBD) and others without RBD (PD-nRBD). Except for pupillomotor function, all the autonomic symptoms were significantly more severe in PD-pRBD group. In PD-nRBD group, caudate striatal binding ratio was negatively correlated with SCOPA-AUT scores, while no significant correlation was observed in PD-pRBD group. Finally, there was a significant difference considering the longitudinal changes of SCOPA-AUT total between PD-pRBD and PD-nRBD groups, suggesting a more severe autonomic decline in PD-pRBD patients. Conclusion:Our results indicate that PD-pRBD patients have more severe autonomic dysfunction. These results support the theory that PD patients can be categorized based on the clinical presentation, possibly representing differences in the disease pathophysiology.
Keywords: Autonomic dysfunction, Parkinson’s disease, REM behavior disorder
