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Wong JC, Li J, Pavlova M, Chen S, Wu A, Wu S, Gao X. Risk factors for probable REM sleep behavior disorder: A community-based study. Neurology 2016; 86:1306-1312. [PMID: 26819459 DOI: 10.1212/wnl.0000000000002414] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 12/14/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine risk factors for REM sleep behavior disorder (RBD) in a large-scale community-based study. METHODS This community-based study included 12,784 Chinese adults (10,556 men and 2,228 women, aged 24 years or older) who were free of Parkinson disease and dementia in 2012. Probable RBD (pRBD) status was determined by a validated questionnaire (Chinese RBD questionnaire-Hong Kong) in 2012. Potential risk factors-including age, sex, smoking, socioeconomic status, physical activity, obesity, consumption of tea (surrogate for caffeine intake) and alcohol, serum concentrations of lipids and glucose, and chronic disease status-were assessed in 2006. Logistic regression was used to calculate odds ratios and 95% confidence intervals and to test differences in prevalence of pRBD across exposures. RESULTS Prevalence of pRBD was 5.9% in men and 4.1% in women. In the fully adjusted model, risk factors that were significantly associated with a higher risk of having pRBD included lower education level, coal mining and other blue collar occupation, lower physical activity level, diabetes or prediabetes, lower body mass index, head injury, higher low-density lipoprotein level, and chronic olfactory and taste dysfunction. In sensitivity analyses, restricting to pRBD cases with symptom onset within 1 year or excluding coal miners or those with history of head injury generated similar results. CONCLUSION We found several potential risk factors for pRBD, including socioeconomic status, head injury, olfactory and taste dysfunction, and various cardiovascular risk factors. Future prospective studies to establish the temporal relationship between these potential risk factors and RBD are warranted.
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Affiliation(s)
- Janice C Wong
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Junjuan Li
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Milena Pavlova
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Shuohua Chen
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Aiping Wu
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Shouling Wu
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
| | - Xiang Gao
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Sprenger FS, Stefanova N, Gelpi E, Seppi K, Navarro-Otano J, Offner F, Vilas D, Valldeoriola F, Pont-Sunyer C, Aldecoa I, Gaig C, Gines A, Cuatrecasas M, Högl B, Frauscher B, Iranzo A, Wenning GK, Vogel W, Tolosa E, Poewe W. Enteric nervous system α-synuclein immunoreactivity in idiopathic REM sleep behavior disorder. Neurology 2015; 85:1761-8. [PMID: 26475692 PMCID: PMC4653104 DOI: 10.1212/wnl.0000000000002126] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/23/2015] [Indexed: 12/24/2022] Open
Abstract
Objective: To investigate the expression of α-synuclein in colonic biopsies of patients with idiopathic REM sleep behavior disorder (iRBD) and address if α-synuclein immunostaining of tissue obtained via colonic biopsies holds promise as a diagnostic biomarker for prodromal Parkinson disease (PD). Methods: Patients with iRBD, patients with PD, and healthy controls were prospectively recruited to undergo colonic biopsies for comparison of α-synuclein immunoreactivity patterns between the groups by using 2 different antibodies. Results: There was no difference in colonic mucosal and submucosal immunostaining between groups using the 15G7 α-synuclein antibody, which was found in almost all participants enrolled in this study. By contrast, immunostaining for serine 129-phosphorylated α-synuclein (pSyn) in submucosal nerve fibers or ganglia was found in none of 14 controls but was observed in 4 of 17 participants with iRBD and 1 out of 19 patients with PD. Conclusions: The present findings of pSyn immunostaining of colonic biopsies in a substantial proportion of iRBD participants raise the possibility that this tissue marker may be a suitable candidate to study further as a prodromal PD marker in at-risk cohorts.
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Affiliation(s)
- Fabienne S Sprenger
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Nadia Stefanova
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Ellen Gelpi
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Klaus Seppi
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Judith Navarro-Otano
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Felix Offner
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Dolores Vilas
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Francesc Valldeoriola
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Claustre Pont-Sunyer
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Iban Aldecoa
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Carles Gaig
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Angels Gines
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Miriam Cuatrecasas
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Birgit Högl
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Birgit Frauscher
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Alex Iranzo
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Gregor K Wenning
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Wolfgang Vogel
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Eduardo Tolosa
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria
| | - Werner Poewe
- From the Departments of Neurology (F.S.S., N.S., K.S., B.H., B.F., G.K.W., W.P.) and Gastroenterology (W.V.), Medical University of Innsbruck, Austria; Neurological Tissue Bank of the Biobanc-Hospital Clinic de Barcelona (E.G.), IDIBAPS; the Departments of Neurology (J.N.-O., D.V., F.V., C.P.-S., C.G., A.I., E.T.), Pathology (I.A., M.C.), and Gastroenterology (A.G.), Hospital Clinic de Barcelona, Spain; and the Institute of Pathology (F.O.), Academic Teaching Hospital, Feldkirch, Austria.
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