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01-02-2015 | Research Article

Prevalence of REM sleep behavior disorder in multiple system atrophy: a multicenter study and meta-analysis

Authors: Jose-Alberto Palma, Clara Fernandez-Cordon, Elizabeth A. Coon, Phillip A. Low, Mitchell G. Miglis, Safwan Jaradeh, Arijit K. Bhaumik, Praveen Dayalu, Elena Urrestarazu, Jorge Iriarte, Italo Biaggioni, Horacio Kaufmann

Published in: Clinical Autonomic Research | Issue 1/2015

Abstract

Objective

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia frequently affecting patients with synucleinopathies, but its exact prevalence in multiple system atrophy (MSA) is unclear. Whether questionnaires alone are sufficient to diagnose RBD is also unknown.

Methods

We performed a cross-sectional study of patients with probable MSA from six academic centers in the US and Europe. RBD was ascertained clinically and with polysomnography; we also performed a meta-analysis according to PRISMA guidelines for studies published before September 2014 that reported the prevalence of RBD in MSA. A random-effects model was constructed using weighted prevalence proportions. Only articles in English were included. Studies were classified into those that ascertained the presence of RBD in MSA clinically and with polysomnography. Case reports or case series (≤5 patients) were not included.

Results

Forty-two patients completed questionnaires and underwent polysomnography. Of those, 32 (76.1 %) had clinically suspected RBD and 34 (81 %) had polysomnography-confirmed RBD. Two patients reported no symptoms of RBD but had polysomnography-confirmed RBD. The primary search strategy yielded 374 articles of which 12 met the inclusion criteria. The summary prevalence of clinically suspected RBD was 73 % (95 % CI, 62–84 %) in a combined sample of 324 MSA patients. The summary prevalence of polysomnography-confirmed RBD was 88 % (95 % CI, 79–94 %) in a combined sample of 217 MSA patients.

Interpretation

Polysomnography-confirmed RBD is present in up to 88 % of patients with MSA. RBD was present in some patients that reported no symptoms. More than half of MSA patients report symptoms of RBD before the onset of motor deficits.

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Title: Prevalence of REM sleep behavior disorder in multiple system atrophy: a multicenter study and meta-analysis
Authors: Jose-Alberto Palma
Clara Fernandez-Cordon
Elizabeth A. Coon
Phillip A. Low
Mitchell G. Miglis
Safwan Jaradeh
Arijit K. Bhaumik
Praveen Dayalu
Elena Urrestarazu
Jorge Iriarte
Italo Biaggioni
Horacio Kaufmann
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Clinical Autonomic Research / Issue 1/2015
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-015-0279-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Prevalence of REM sleep behavior disorder in multiple system atrophy: a multicenter study and meta-analysis

Abstract

Objective

Methods

Results

Interpretation

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Interpretation

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