Dream Content Predicts Motor and Cognitive Decline in Parkinson's Disease
Dream Content Predicts Motor and Cognitive Decline in Parkinson's Disease
复制标题
DOI：
10.1002/mdc3.13318
复制
发表时间：
2021-08-09
影响因子：
4
通讯作者：
Otaiku, Abidemi I.
中科院分区：
文献类型：
--
作者：
Otaiku, Abidemi I.
背景：帕金森氏病（PD）的梦内容改变与运动和认知功能障碍相关。尽管最近的研究表明，PD中异常的梦境内容也可能预测认知能力下降，但梦境内容与PD中运动能力下降之间的关系尚不清楚。目的：探讨PD患者异常梦境内容是否预示着运动和认知能力下降。方法：数据来自帕金森进展标志物倡议队列研究。在基线和60个月的随访中对患者进行评估，使用经过验证的临床量表，包括快速眼动睡眠行为障碍筛查问卷（RBDSQ）、蒙特利尔认知评估（MoCA）和运动障碍学会统一帕金森病评定量表第三部分（MDS-UPDRS III）。使用RBDSQ第2项对患者进行二分类，该项目询问他们是否经常在梦中经历攻击。回归分析用于评估基线时频繁的攻击性梦是否预测MDS-UPDRS III和MoCA评分的纵向变化以及Hoehn和Yahr阶段3 （H&Y >= 3）和认知障碍的进展。结果：在这些患者中，58/224（25.9%）在基线时报告频繁的攻击性梦。侵略性的梦预示着MDS-UPDRS III分数的快速增长（beta - 4.64; P - 0.007）和MoCA分数的快速下降（beta - 1.49; P - 0.001）。此外，他们在60个月内有6倍和2倍的风险发展为H&Y >= 3（优势比[OR] - 5.82; P - 0.005）和认知障碍（OR, 2.35; P = 0.023）。在对潜在混杂因素进行调整后，这些关联仍然很强。结论：本研究首次证明，新诊断的PD患者频繁的攻击性梦可能独立预测早期运动和认知能力下降。
Background: Dream content alterations in Parkinson's disease (PD) are associated with motor and cognitive dysfunction cross-sectionally. Although recent studies suggest abnormal dream content in PD might also predict cognitive decline, the relationship between dream content and motor decline in PD remains unknown.Objective: To investigate whether abnormal dream content in PD predicts both motor and cognitive decline.Methods: Data were obtained from the Parkinson's Progression Markers Initiative cohort study. Patients were evaluated at baseline and at the 60-month follow-up, with validated clinical scales, including the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Montreal Cognitive Assessment (MoCA), and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III). Patients were dichotomized using RBDSQ item 2, which inquires whether they frequently experience aggression in their dreams. Regression analyses were used to assess whether frequent aggressive dreams at baseline predicted longitudinal changes in MDS-UPDRS III and MoCA scores as well as progression to Hoehn and Yahr stage 3 (H&Y >= 3) and cognitive impairment.Results: Of the patients, 58/224 (25.9%) reported frequent aggressive dreams at baseline. Aggressive dreams predicted a faster increase in MDS-UPDRS III scores (beta - 4.64; P - 0.007) and a faster decrease in MoCA scores (beta - 1.49; P - 0.001). Furthermore, they conferred a 6-fold and 2-fold risk for progressing to H&Y >= 3 (odds ratio [OR] - 5.82; P - 0.005) and cognitive impairment (OR, 2.35; P = 0.023) within 60 months. These associations remained robust when adjusting for potential confounders.Conclusions: This study demonstrates for the first time that frequent aggressive dreams in newly diagnosed PD may independently predict early motor and cognitive decline.