INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #61 REM Sleep Behavior Disorder: Cognitive Performance, Functional Outcomes, and Quality of Life in Parkinson’s Disease Alyssa Kaser, University of Texas Southwestern Medical Center, Dallas, United States Anthony Longoria, University of Texas Southwestern Medical Center, Dallas, United States Umar Yazdani, University of Texas Southwestern Medical Center, Dallas, United States Holly Winiarski, University of Texas Southwestern Medical Center, Dallas, United States Brittany Walls, University of Texas Southwestern Medical Center, Dallas, United States Frederick Hitti, University of Texas Southwestern Medical Center, Dallas, United States Nader Pouratian, University of Texas Southwestern Medical Center, Dallas, United States Vibhash Sharma, University of Texas Southwestern Medical Center, Dallas, United States Oscar Kronenberger, University of Texas Southwestern Medical Center, Dallas, United States Laura Lacritz, University of Texas Southwestern Medical Center, Dallas, United States Category: Neurodegenerative Disorders Keyword 1: Parkinson's disease Keyword 2: sleep disorders Keyword 3: everyday functioning Objective: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a lack of muscle atonia during REM sleep, resulting in complex dream enactment behaviors. RBD has been associated with the development of various neurodegenerative disorders, with RBD co-occurring in approximately 35-50% of individuals with Parkinson’s disease (PD) and often emerging prior to motor symptom onset. Additionally, RBD is suggested to be a risk factor for subsequent cognitive impairment and faster disease progression, but further research is needed to understand the impact RBD has on daily functioning and overall quality of life in PD. The current study examined cognitive performance, functional capacity, and quality of life outcomes in PD patients with and without RBD. Participants and Methods: The sample included 191 individuals with advanced PD, with (RBD+; n=59) or without RBD (RBD-; n=132), being considered for deep brain stimulation (DBS). The evaluation process included a neurological assessment, clinical questionnaires, self-report and performance-based measures of daily functioning, and a neuropsychological battery measuring executive functions, attention, processing speed, visuospatial abilities, memory, and language. Raw cognitive test scores were converted to demographically-adjusted (age, sex, and/or education) T scores and then averaged within each cognitive domain to create domain-specific T scores. Functional capacity and quality of life outcomes were measured using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Parkinson's Disease Questionnaire (PDQ-39). Comparisons between RBD+ and RBD- groups were made using two-sample t-tests for continuous variables and chi-square tests of independence for categorical variables. The proportion of impaired cognitive tests (<1SD below mean) were examined in RBD+/- groups. Results: Cognitive performances were not significantly different between RBD+/- groups. However, RBD+ individuals demonstrated significantly lower (p<.05) delayed visual memory performances on the Rey–Osterrieth Complex Figure (ROCF; RBD-M_T=49.17 vs. RBD+M_T=44.33). Overall, mean cognitive domain scores fell in the average range across groups, yet approximately 30% of individuals had four or more impaired test scores in both groups. RBD+ was associated with more impairment in non-motor experiences of daily living (RBD-M_{MDS-UPDRS Part 1}=12.02 vs. RBD+M_{MDS-UPDRS Part 1}=15.32, p<.01) and a lower quality of life (RBD-M_{PDQ-39 Total}=26.89 vs. RBD+M_{PDQ-39 Total}=35.47, p<.01) compared to RBD-. RBD+ individuals reported experiencing significant difficulties in mobility (RBD-M=33.97 vs. RBD+M=44.47, p<.05), emotional well-being (RBD-M=20.97 vs. RBD+M=30.42, p<.01), stigma (RBD-M=23.44 vs. RBD+M=35.08, p<.01), cognitive impairment (RBD-M=21.55 vs. RBD+M=33.20, p<.001), and bodily discomfort (RBD-M=36.84 vs. RBD+M=48.53, p<.01), as measured by the PDQ-39 dimensions of daily living. The RBD+ group also demonstrated significantly more depressive symptoms on the Quick Inventory of Depressive Symptomatology (QIDS; RBD-M=7.42 vs. RBD+M=9.36, p<0.05). Conclusions: Although cognitive differences were not seen in this sample of RBD+/- individuals with PD, results suggest increased subjective cognitive decline and poorer health-related quality of life among those with RBD. These findings highlight the importance of assessing for RBD in patients with PD, as they may experience heightened impairment in daily functioning and an overall diminished sense of well-being. Further research is needed to replicate these results in a non-DBS sample and follow individuals prospectively to explore differences in PD progression.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #61

REM Sleep Behavior Disorder: Cognitive Performance, Functional Outcomes, and Quality of Life in Parkinson’s Disease

Alyssa Kaser, University of Texas Southwestern Medical Center, Dallas, United States
Anthony Longoria, University of Texas Southwestern Medical Center, Dallas, United States
Umar Yazdani, University of Texas Southwestern Medical Center, Dallas, United States
Holly Winiarski, University of Texas Southwestern Medical Center, Dallas, United States
Brittany Walls, University of Texas Southwestern Medical Center, Dallas, United States
Frederick Hitti, University of Texas Southwestern Medical Center, Dallas, United States
Nader Pouratian, University of Texas Southwestern Medical Center, Dallas, United States
Vibhash Sharma, University of Texas Southwestern Medical Center, Dallas, United States
Oscar Kronenberger, University of Texas Southwestern Medical Center, Dallas, United States
Laura Lacritz, University of Texas Southwestern Medical Center, Dallas, United States

Category: Neurodegenerative Disorders

Keyword 1: Parkinson's disease
Keyword 2: sleep disorders
Keyword 3: everyday functioning

Objective:

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a lack of muscle atonia during REM sleep, resulting in complex dream enactment behaviors. RBD has been associated with the development of various neurodegenerative disorders, with RBD co-occurring in approximately 35-50% of individuals with Parkinson’s disease (PD) and often emerging prior to motor symptom onset. Additionally, RBD is suggested to be a risk factor for subsequent cognitive impairment and faster disease progression, but further research is needed to understand the impact RBD has on daily functioning and overall quality of life in PD. The current study examined cognitive performance, functional capacity, and quality of life outcomes in PD patients with and without RBD.

Participants and Methods:

The sample included 191 individuals with advanced PD, with (RBD+; n=59) or without RBD (RBD-; n=132), being considered for deep brain stimulation (DBS). The evaluation process included a neurological assessment, clinical questionnaires, self-report and performance-based measures of daily functioning, and a neuropsychological battery measuring executive functions, attention, processing speed, visuospatial abilities, memory, and language. Raw cognitive test scores were converted to demographically-adjusted (age, sex, and/or education) T scores and then averaged within each cognitive domain to create domain-specific T scores. Functional capacity and quality of life outcomes were measured using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Parkinson's Disease Questionnaire (PDQ-39). Comparisons between RBD+ and RBD- groups were made using two-sample t-tests for continuous variables and chi-square tests of independence for categorical variables. The proportion of impaired cognitive tests (<1SD below mean) were examined in RBD+/- groups.

Results:

Cognitive performances were not significantly different between RBD+/- groups. However, RBD+ individuals demonstrated significantly lower (p<.05) delayed visual memory performances on the Rey–Osterrieth Complex Figure (ROCF; RBD-M_T=49.17 vs. RBD+M_T=44.33). Overall, mean cognitive domain scores fell in the average range across groups, yet approximately 30% of individuals had four or more impaired test scores in both groups. RBD+ was associated with more impairment in non-motor experiences of daily living (RBD-M_{MDS-UPDRS Part 1}=12.02 vs. RBD+M_{MDS-UPDRS Part 1}=15.32, p<.01) and a lower quality of life (RBD-M_{PDQ-39 Total}=26.89 vs. RBD+M_{PDQ-39 Total}=35.47, p<.01) compared to RBD-. RBD+ individuals reported experiencing significant difficulties in mobility (RBD-M=33.97 vs. RBD+M=44.47, p<.05), emotional well-being (RBD-M=20.97 vs. RBD+M=30.42, p<.01), stigma (RBD-M=23.44 vs. RBD+M=35.08, p<.01), cognitive impairment (RBD-M=21.55 vs. RBD+M=33.20, p<.001), and bodily discomfort (RBD-M=36.84 vs. RBD+M=48.53, p<.01), as measured by the PDQ-39 dimensions of daily living. The RBD+ group also demonstrated significantly more depressive symptoms on the Quick Inventory of Depressive Symptomatology (QIDS; RBD-M=7.42 vs. RBD+M=9.36, p<0.05).

Conclusions:

Although cognitive differences were not seen in this sample of RBD+/- individuals with PD, results suggest increased subjective cognitive decline and poorer health-related quality of life among those with RBD. These findings highlight the importance of assessing for RBD in patients with PD, as they may experience heightened impairment in daily functioning and an overall diminished sense of well-being. Further research is needed to replicate these results in a non-DBS sample and follow individuals prospectively to explore differences in PD progression.