The risk of neurodegeneration in REM sleep behavior disorder: A systematic review and meta-analysis of longitudinal studies

Andrea Galbiati, Laura Verga, Enrico Giora, Marco Zucconi, Luigi Ferini-Strambi

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Several studies report an association between REM Sleep Behavior Disorder (RBD) and neurodegenerative diseases, in particular synucleinopathies. Interestingly, the onset of RBD precedes the development of neurodegeneration by several years. This review and meta-analysis aims to establish the rate of conversion of RBD into neurodegenerative diseases. Longitudinal studies were searched from the PubMed, Web of Science, and SCOPUS databases. Using random-effect modeling, we performed a meta-analysis on the rate of RBD conversions into neurodegeneration. Furthermore, we fitted a Kaplan-Meier analysis and compared the differences between survival curves of different diseases with log-rank tests. The risk for developing neurodegenerative diseases was 33.5% at five years follow-up, 82.4% at 10.5 years and 96.6% at 14 years. The average conversion rate was 31.95% after a mean duration of follow-up of 4.75 ± 2.43 years. The majority of RBD patients converted to Parkinson's Disease (43%), followed by Dementia with Lewy Bodies (25%). The estimated risk for RBD patients to develop a neurodegenerative disease over a long-term follow-up is more than 90%. Future studies should include control group for the evaluation of REM sleep without atonia as marker for neurodegeneration also in non-clinical population and target RBD as precursor of neurodegeneration to develop protective trials.

Original languageEnglish
Pages (from-to)37-46
Number of pages10
JournalSleep Medicine Reviews
Volume43
Early online date8 Nov 2018
DOIs
Publication statusPublished - Feb 2019

Keywords

  • DELAYED EMERGENCE
  • DEMENTIA
  • Dementia with Lewy bodies
  • EARLY MARKER
  • FOLLOW-UP
  • IMPENDING NEURODEGENERATION
  • MILD COGNITIVE IMPAIRMENT
  • Neurodegeneration
  • PARKINSONS-DISEASE
  • PREDICTS EARLY TRANSITION
  • Parkinson disease
  • RBD
  • REM sleep behavior disorder
  • REM sleep without atonia
  • Synucleinopathies
  • TREATMENT OUTCOMES

Cite this

Galbiati, Andrea ; Verga, Laura ; Giora, Enrico ; Zucconi, Marco ; Ferini-Strambi, Luigi. / The risk of neurodegeneration in REM sleep behavior disorder : A systematic review and meta-analysis of longitudinal studies. In: Sleep Medicine Reviews. 2019 ; Vol. 43. pp. 37-46.
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abstract = "Several studies report an association between REM Sleep Behavior Disorder (RBD) and neurodegenerative diseases, in particular synucleinopathies. Interestingly, the onset of RBD precedes the development of neurodegeneration by several years. This review and meta-analysis aims to establish the rate of conversion of RBD into neurodegenerative diseases. Longitudinal studies were searched from the PubMed, Web of Science, and SCOPUS databases. Using random-effect modeling, we performed a meta-analysis on the rate of RBD conversions into neurodegeneration. Furthermore, we fitted a Kaplan-Meier analysis and compared the differences between survival curves of different diseases with log-rank tests. The risk for developing neurodegenerative diseases was 33.5{\%} at five years follow-up, 82.4{\%} at 10.5 years and 96.6{\%} at 14 years. The average conversion rate was 31.95{\%} after a mean duration of follow-up of 4.75 ± 2.43 years. The majority of RBD patients converted to Parkinson's Disease (43{\%}), followed by Dementia with Lewy Bodies (25{\%}). The estimated risk for RBD patients to develop a neurodegenerative disease over a long-term follow-up is more than 90{\%}. Future studies should include control group for the evaluation of REM sleep without atonia as marker for neurodegeneration also in non-clinical population and target RBD as precursor of neurodegeneration to develop protective trials.",
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author = "Andrea Galbiati and Laura Verga and Enrico Giora and Marco Zucconi and Luigi Ferini-Strambi",
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The risk of neurodegeneration in REM sleep behavior disorder : A systematic review and meta-analysis of longitudinal studies. / Galbiati, Andrea; Verga, Laura; Giora, Enrico; Zucconi, Marco; Ferini-Strambi, Luigi.

In: Sleep Medicine Reviews, Vol. 43, 02.2019, p. 37-46.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - The risk of neurodegeneration in REM sleep behavior disorder

T2 - A systematic review and meta-analysis of longitudinal studies

AU - Galbiati, Andrea

AU - Verga, Laura

AU - Giora, Enrico

AU - Zucconi, Marco

AU - Ferini-Strambi, Luigi

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2019/2

Y1 - 2019/2

N2 - Several studies report an association between REM Sleep Behavior Disorder (RBD) and neurodegenerative diseases, in particular synucleinopathies. Interestingly, the onset of RBD precedes the development of neurodegeneration by several years. This review and meta-analysis aims to establish the rate of conversion of RBD into neurodegenerative diseases. Longitudinal studies were searched from the PubMed, Web of Science, and SCOPUS databases. Using random-effect modeling, we performed a meta-analysis on the rate of RBD conversions into neurodegeneration. Furthermore, we fitted a Kaplan-Meier analysis and compared the differences between survival curves of different diseases with log-rank tests. The risk for developing neurodegenerative diseases was 33.5% at five years follow-up, 82.4% at 10.5 years and 96.6% at 14 years. The average conversion rate was 31.95% after a mean duration of follow-up of 4.75 ± 2.43 years. The majority of RBD patients converted to Parkinson's Disease (43%), followed by Dementia with Lewy Bodies (25%). The estimated risk for RBD patients to develop a neurodegenerative disease over a long-term follow-up is more than 90%. Future studies should include control group for the evaluation of REM sleep without atonia as marker for neurodegeneration also in non-clinical population and target RBD as precursor of neurodegeneration to develop protective trials.

AB - Several studies report an association between REM Sleep Behavior Disorder (RBD) and neurodegenerative diseases, in particular synucleinopathies. Interestingly, the onset of RBD precedes the development of neurodegeneration by several years. This review and meta-analysis aims to establish the rate of conversion of RBD into neurodegenerative diseases. Longitudinal studies were searched from the PubMed, Web of Science, and SCOPUS databases. Using random-effect modeling, we performed a meta-analysis on the rate of RBD conversions into neurodegeneration. Furthermore, we fitted a Kaplan-Meier analysis and compared the differences between survival curves of different diseases with log-rank tests. The risk for developing neurodegenerative diseases was 33.5% at five years follow-up, 82.4% at 10.5 years and 96.6% at 14 years. The average conversion rate was 31.95% after a mean duration of follow-up of 4.75 ± 2.43 years. The majority of RBD patients converted to Parkinson's Disease (43%), followed by Dementia with Lewy Bodies (25%). The estimated risk for RBD patients to develop a neurodegenerative disease over a long-term follow-up is more than 90%. Future studies should include control group for the evaluation of REM sleep without atonia as marker for neurodegeneration also in non-clinical population and target RBD as precursor of neurodegeneration to develop protective trials.

KW - DELAYED EMERGENCE

KW - DEMENTIA

KW - Dementia with Lewy bodies

KW - EARLY MARKER

KW - FOLLOW-UP

KW - IMPENDING NEURODEGENERATION

KW - MILD COGNITIVE IMPAIRMENT

KW - Neurodegeneration

KW - PARKINSONS-DISEASE

KW - PREDICTS EARLY TRANSITION

KW - Parkinson disease

KW - RBD

KW - REM sleep behavior disorder

KW - REM sleep without atonia

KW - Synucleinopathies

KW - TREATMENT OUTCOMES

U2 - 10.1016/j.smrv.2018.09.008

DO - 10.1016/j.smrv.2018.09.008

M3 - Review article

C2 - 30503716

VL - 43

SP - 37

EP - 46

JO - Sleep Medicine Reviews

JF - Sleep Medicine Reviews

SN - 1087-0792

ER -