Baseline characteristics of the North American prodromal Synucleinopathy cohort.
Document Type
Article
Abstract
OBJECTIVE: Rapid eye movement (REM) sleep behavior disorder (RBD) is widely considered a prodromal synucleinopathy, as most with RBD develop overt synucleinopathy within ~10 years. Accordingly, RBD offers an opportunity to test potential treatments at the earliest stages of synucleinopathy. The North American Prodromal Synucleinopathy (NAPS) Consortium has created a multisite RBD participant, primarily clinic-based cohort to better understand characteristics at diagnosis, and in future work, identify predictors of phenoconversion, develop synucleinopathy biomarkers, and enable early stage clinical trial enrollment.
METHODS: Participants ≥18 years of age with overnight polysomnogram-confirmed RBD without Parkinson's disease, dementia, multiple system atrophy, or narcolepsy were enrolled from nine sites across North America (8/2018 to 4/2021). Data collection included family/personal history of RBD and standardized assessments of cognitive, motor, sensory, and autonomic function.
RESULTS: Outcomes are primarily reported based on sex (361 total: n = 295 male, n = 66 female), and secondarily based on history of antidepressant use (n = 200 with, n = 154 without; with correction for sex differences) and based on extent of synucleinopathy burden (n = 56 defined as isolated RBD, n = 305 defined as RBD+ [i.e., exhibiting ≥1 abnormality]). Overall, these participants commonly demonstrated abnormalities in global cognition (MoCA; 38%), motor function (alternate tap test; 48%), sensory (BSIT; 57%), autonomic function (orthostatic hypotension, 38.8%), and anxiety/depression (BAI and PHQ-9; 39.3% and 31%, respectively).
INTERPRETATION: These RBD participants, assessed with extensive history, demographic, cognitive, motor, sensory, and autonomic function demonstrated a lack of sex differences and high frequency of concomitant neurological abnormalities. These participants will be valuable for future longitudinal study and neuroprotective clinical trials.
Publication Date
2-8-2023
Publication Title
Ann Clin Transl Neurol
ISSN
2328-9503
PubMed ID
36751940
Digital Object Identifier (DOI)
10.1002/acn3.51738
Recommended Citation
Elliott, Jonathan E; Lim, Miranda M; Keil, Allison T; Postuma, Ronald B; Pelletier, Amelie; Gagnon, Jean-François; St Louis, Erik K; Forsberg, Leah K; Fields, Julie A; Huddleston, Daniel E; Bliwise, Donald L; Avidan, Alon Y; Howell, Michael J; Schenck, Carlos H; McLeland, Jennifer; Criswell, Susan R; Videnovic, Aleksandar; During, Emmanuel H; Miglis, Mitchell G; Shprecher, David R; Lee-Iannotti, Joyce K; Boeve, Bradley F; and Ju, Yo-El S, "Baseline characteristics of the North American prodromal Synucleinopathy cohort." (2023). Neurology. 1306.
https://scholar.barrowneuro.org/neurology/1306