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

  • Maria Livia Fantini
  • Franck Durif
  • Ana Marques


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.


REM sleep behavior disorder Parkinson’s disease Apathy Impulse-control disorders Addiction Neuropsychiatric features Reward system 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Maria Livia Fantini
    • 1
    • 2
    • 3
  • Franck Durif
    • 1
    • 3
  • Ana Marques
    • 1
    • 3
  1. 1.EA 7280 Laboratory of Neuropychopharmacology of the Subcortical Dopaminergic Systems, UFR Medecine, Université Clermont AuvergneClermont-FerrandFrance
  2. 2.EEG and Sleep Unit, Neurology Service, CHU Clermont-FerrandClermont-FerrandFrance
  3. 3.Neurology Service, CHU Clermont-FerrandClermont-FerrandFrance

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