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Published online before print January 23, 2008, doi:10.1212/01.wnl.0000286943.79593.a6)
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NEUROLOGY 2008;70:1250-1257
© 2008 American Academy of Neurology

Executive dysfunction and memory impairment in idiopathic REM sleep behavior disorder

J. Massicotte-Marquez, BSc, A. Décary, PhD, J-F Gagnon, PhD, M. Vendette, MSc, A. Mathieu, MSc, R. B. Postuma, MD, J. Carrier, PhD and J. Montplaisir, MD, PhD

From Centre d’Étude du Sommeil et des Rythmes Biologiques (J.M.-M., A.D., J.-F.G., M.V., A.M., J.C., J.M.), Hôpital du Sacré-Cœur de Montréal; and Department of Neurology (R.B.P.), Montreal General Hospital, Québec, Canada.

Address correspondence and reprint requests to Dr. Jacques Montplaisir, Centre d’Étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest Montréal, Québec, Canada H4J 1C5 JY.Montplaisir{at}UMontreal.CA

Background: Idiopathic REM sleep behavior disorder (iRBD) might be a stage in the development of neurodegenerative disorders, especially Parkinson disease and dementia with Lewy bodies. Recent studies showing a slowing of waking EEG in iRBD suggest that iRBD is associated with cognitive impairment.

Objective: To compare patients with iRBD on measures of cognitive function and quantitative waking EEG.

Methods: Fourteen patients with iRBD and 14 healthy control subjects matched for age and educational level were studied. Subjects underwent an extensive neuropsychological evaluation and waking EEG recordings.

Results: Compared to controls, patients with iRBD showed a lower performance on neuropsychological tests measuring attention, executive functions, and verbal memory. Moreover, patients with iRBD showed EEG slowing (higher delta and theta power) during wakefulness in all brain areas compared to controls. However, no correlation was found between performance on cognitive tests and quantitative waking EEG in patients with iRBD.

Conclusion: This study shows a co-occurrence of impaired cognitive profile and waking EEG slowing in patients with idiopathic REM sleep behavior disorder similar to that observed in early stages of some synucleinopathies.

Abbreviations: ANOVAs = analyses of variance; BDI-II = Beck-II Depression Inventory; DLB = dementia with Lewy bodies; DRS = Dementia Rating Scale; EOG = electro-oculograms; FCRTT = four choice reaction time test; iRBD = idiopathic REM sleep behavior disorder; MA = microarousals; MMSE = Mini-Mental State Examination; MSA = multiple system atrophy; NA = not applicable; NS = not significant; PD = Parkinson disease; PLMS = periodic leg movements during sleep; PLMW = periodic leg movements during wakefulness; PSG = polysomnography; qEEG = quantitative EEG; SWS = slow wave sleep; UPDRS = Unified Parkinson’s Disease Rating Scale; WAIS = Wechsler Adult Intelligence Scale.

e-Pub ahead of print on January 23, 2008, at www.neurology.org.

Supported by the Canadian Institutes of Health Research (postdoctoral studentship to J.F.G. and grant to J.M., J.C., A.D.) and the "Fonds de la Recherche en Santé du Québec" (studentship to J.M.M. and M.V, scholarship to J.C.).

Disclosure: J. Massicotte-Marquez, A. Décary, J.F. Gagnon, M. Vendette, A. Mathieu, and J. Carrier report no conflicts of interest. R.B. Postuma received personal compensation from Novartis for consulting services. J.Y. Montplaisir received personal compensation as consultant (Boehringer Ingelheim, Servier, Shire Biochem), speaker (Boehringer, Shire), and received financial support for research activities from Sanofi Synthelabo, GlaxoSmithKline.

Received April 4, 2007. Accepted in final form August 14, 2007.






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