Sleep disorder can cause neurodegenerative conditions like Parkinson’s disease that manifest several decades later. In this case, the dreams are accompanied by excessive movement. Bradley Boeve, MD, of the Mayo Clinic in Rochester, Minn., and colleagues noted that among 27 patients with Parkinson’s disease, multiple system atrophy, or dementia with Lewy bodies, the median time between the onset of REM sleep behavior disorder and symptom onset of the neurodegenerative condition was 25 years. On the other case, there was a time span that reached 50 years. According to previous study, it has been found that REM sleep behavior disorder precedes Parkinson’s disease and related conditions by about a decade in most cases, although there were occasional cases with a wider interval. And those cases have illustrated that the synucleinopathies may have extremely long courses, with preclinical periods extending back decades in at least some cases.
Actually, a long preclinical phase has important implications for epidemiologic studies, as well as for “the development of therapies that might slow or halt alpha-synucleinopathy progression, which could be implemented well before the cognitive and motor features are manifest. The researchers used Mayo Clinic records to identify 27 patients with some form of synucleinopathy who had onset of REM sleep behavior disorder at least 15 years before neurodegenerative symptoms arose. The patients’ mean age at onset of the sleep disorder was 49 and at onset of neurologic symptoms were 72.
From that case, the result noted that most of the people who have this condition are male with 89%. At the latest follow-up, nearly two-thirds of the patients (63%) had developed either Parkinson’s disease dementia or dementia with Lewy bodies. About three-quarters (74%) had concomitant autonomic dysfunction, which was mostly expressed as postural related lightheadedness but also included urinary incontinence or retention and constipation. Actually, the study, which using a convenience sample of patients, cannot establish the incidence or prevalence of long intervals between REM sleep disorder and the synucleinopathies.