TY - JOUR
T1 - REM Sleep without Atonia and Gait Impairment in People with Mild-to-Moderate Parkinson's Disease
AU - Amundsen-Huffmaster, Sommer L.
AU - Petrucci, Matthew N.
AU - Linn-Evans, Maria E.
AU - Chung, Jae Woo
AU - Howell, Michael J.
AU - Videnovic, Aleksandar
AU - Tuite, Paul J.
AU - Cooper, Scott E.
AU - MacKinnon, Colum D.
N1 - Publisher Copyright:
© 2021 - IOS Press. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Subtle gait deficits can be seen in people with idiopathic rapid eye movement (REM) sleep behavior disorder (RBD), a prodromal stage of Parkinson's disease (PD) and related alpha-synucleinopathies. It is unknown if the presence and level of REM sleep without atonia (RSWA, the electromyographic hallmark of RBD) is related to the severity of gait disturbances in people with PD. Objective: We hypothesized that gait disturbances in people with mild-to-moderate PD would be greater in participants with RSWA compared to those without RSWA and matched controls, and that gait impairment would correlate with measures of RSWA. Methods: Spatiotemporal characteristics of gait were obtained from 41 people with PD and 21 age-matched controls. Overnight sleep studies were used to quantify muscle activity during REM sleep and group participants with PD into those with RSWA (PD-RSWA+, n=22) and normal REM sleep muscle tone (PD-RSWA-, n=19). Gait characteristics were compared between groups and correlated to RSWA. Results: The PD-RSWA+ group demonstrated significantly reduced gait speed and step lengths and increased stance and double support times compared to controls, and decreased speed and cadence and increased stride velocity variability compared to PD-RSWA- group. Larger RSWA scores were correlated with worse gait impairment in the PD group. Conclusion: The presence and level of muscle tone during REM sleep is associated with the severity of gait disturbances in PD. Pathophysiological processes contributing to disordered gait may occur earlier and/or progress more rapidly in people with PD and RBD.
AB - Background: Subtle gait deficits can be seen in people with idiopathic rapid eye movement (REM) sleep behavior disorder (RBD), a prodromal stage of Parkinson's disease (PD) and related alpha-synucleinopathies. It is unknown if the presence and level of REM sleep without atonia (RSWA, the electromyographic hallmark of RBD) is related to the severity of gait disturbances in people with PD. Objective: We hypothesized that gait disturbances in people with mild-to-moderate PD would be greater in participants with RSWA compared to those without RSWA and matched controls, and that gait impairment would correlate with measures of RSWA. Methods: Spatiotemporal characteristics of gait were obtained from 41 people with PD and 21 age-matched controls. Overnight sleep studies were used to quantify muscle activity during REM sleep and group participants with PD into those with RSWA (PD-RSWA+, n=22) and normal REM sleep muscle tone (PD-RSWA-, n=19). Gait characteristics were compared between groups and correlated to RSWA. Results: The PD-RSWA+ group demonstrated significantly reduced gait speed and step lengths and increased stance and double support times compared to controls, and decreased speed and cadence and increased stride velocity variability compared to PD-RSWA- group. Larger RSWA scores were correlated with worse gait impairment in the PD group. Conclusion: The presence and level of muscle tone during REM sleep is associated with the severity of gait disturbances in PD. Pathophysiological processes contributing to disordered gait may occur earlier and/or progress more rapidly in people with PD and RBD.
KW - Parkinson's disease
KW - REM sleep without atonia
KW - gait
UR - http://www.scopus.com/inward/record.url?scp=85104335842&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85104335842&partnerID=8YFLogxK
U2 - 10.3233/JPD-202098
DO - 10.3233/JPD-202098
M3 - Article
C2 - 33523016
AN - SCOPUS:85104335842
SN - 1877-7171
VL - 11
SP - 767
EP - 778
JO - Journal of Parkinson's Disease
JF - Journal of Parkinson's Disease
IS - 2
ER -