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Neuropsychological Aspects: Impulse-Control Disorders and Other Neuropsychiatric Features in RBD

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Rapid-Eye-Movement Sleep Behavior Disorder

Abstract

An increased frequency of neuropsychiatric disorders, including apathy, anxiety, depression, and impulse-control disorders, has been occasionally reported in patients with either idiopathic RBD (iRBD) or RBD associated to Parkinson’s disease (PD-RBD). In particular, apathy was found to be more frequent in probable (questionnaire-assessed) iRBD compared to the general population and in PD patients with RBD compared to those without RBD, after controlling for disease duration and severity, depression, and cognitive function. A higher frequency of depressive symptoms has seldom been reported in iRBD and PD-RBD, but results are scant and not unequivocal. Some studies looked at addictive behaviors in RBD, finding increased smoking in iRBD compared to healthy controls, with no difference in caffeine or alcohol consumption. Likewise, PD patients with RBD have been found to smoke more than those without RBD. We recently reported an up to fivefold increased risk of impulse-control disorders (ICDs) symptoms in PD patients with probable RBD, while other studies failed to find such an association. Furthermore, we observed an increased frequency of video-polysomnographically (vPSG)-confirmed RBD in PD patients with ICDs compared to those without ICDs (odds ratio, 4.8). More recently, we found a hypoactivation of the mesocorticolimbic pathway by fMRI during an incentive monetary task in PD patients with RBD, compared to PD without RBD and healthy controls. Abnormalities in the reward system may underlie behavioral disturbances such as increased apathy and addictive behaviors in PD patients with RBD. In summary RBD, at least in PD, is associated with an increased neuropsychiatric burden. Further studies are warranted to better assess neuropsychiatric features in both idiopathic and parkinsonian RBD populations.

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Authors and Affiliations

  1. EA 7280 Laboratory of Neuropychopharmacology of the Subcortical Dopaminergic Systems, UFR Medecine, Université Clermont Auvergne, Clermont-Ferrand, France

    Maria Livia Fantini, Franck Durif & Ana Marques

  2. EEG and Sleep Unit, Neurology Service, CHU Clermont-Ferrand, Clermont-Ferrand, France

    Maria Livia Fantini

  3. Neurology Service, CHU Clermont-Ferrand, Clermont-Ferrand, France

    Maria Livia Fantini, Franck Durif & Ana Marques

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  1. Maria Livia Fantini
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  2. Franck Durif
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Editors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, MN, USA

    Carlos H. Schenck

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

  3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Aleksandar Videnovic

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Fantini, M.L., Durif, F., Marques, A. (2019). Neuropsychological Aspects: Impulse-Control Disorders and Other Neuropsychiatric Features in RBD. In: Schenck, C., Högl, B., Videnovic, A. (eds) Rapid-Eye-Movement Sleep Behavior Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-90152-7_35

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