Clinical Characteristics Of Rapid Eye Movement Sleep Behavior Disorder In Parkinson’s Disease And Its Correlation With Constipation

Objective: Rapid eye movement sleep behavior disorder(RBD)and constipation are common non-motor symptoms of Parkinson’s disease.So far,the relationship between these symptoms remains unclear.The purpose of this study was to investigate the relationship between RBD and constipation.At the same time,the incidence of RBD symptoms and its related factors were analyzed.Methods: 1.This study enrolled 113 patients with Parkinson’s disease without dementia who visited the Department of Neurology at Shengjing Hospital of China Medical University from May 2019 to August 2020.General information of the patients was recorded,including age,sex,body mass index(BMI),education,PD course,smoking history,alcohol consumption history,and current anti-PD medication dosage.To explore the risk factors of RBD.The second and third parts of the International Movement Disorders Association Uniform Parkinson’s Disease Rating Scale(MDS-UPDRSII,III)and Hoehn-Yahr staging were completed to evaluate the severity of motor symptoms in Parkinson’s disease patients.Through the Movement Disorder Society Unified Parkinson’s Disease Rating Scale I(MDS-UPDRSI),The Non-Motor Symptoms Questionnaire(NMSQ),The Scales for Outcomes in Parkinson’s disease–Autonomic(SCOPA-AUT)the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(Mo CA),the Parkinson’s disease sleep scale(PDSS),the Epworth sleepiness scale(ESS),The Overactive Bladder Symptom Score(OABSS)evaluation of motor symptoms occur.The Parkinson’s Disease Questionnaire-39(PDQ-39)was used to evaluate the patients’ quality of life.The presence of RBD was determined according to the RBD screening questionnaire(RBDSQ).RBDSQ score of 5 was used as the cutoff value in this study to distinguish patients with probable RBD(p RBD;RBDSQ≥5)and without RBD(n RBD;RBDSQ<5).Constipation was diagnosed according to the Rome IV diagnostic criteria.And Constipation severity was assessed using the constipation scoring system(CSS).2.All patients were divided into PD+p RBD group(RBDSQ≥5)and PD-RBD group(RBDSQ < 5),and the clinical characteristics of patients with probable RBD were analyzed.Risk factors associated with probable RBD were also analyzed.3.All constipation patients were divided into constipation and RBD group(PD+ PRBD +C group)and constipation without RBD group(PD-RBD+C group),to explore the relationship between probable RBD and the severity of constipation,the course of constipation,and the clinical characteristics of constipation.Result:1.Among the 113 PD patients included in this study,the incidence of possible RBD was 39.8% and the incidence of constipation was 60.2%.2.The equivalent dose of levodopa was higher in PD patients with RBD,and the non-tremor subtype was more common.Non-motor symptoms questionnaire(NMSQ)scores,Movement Disorder Society Unified Parkinson’s Disease Rating Scale I(MDS-UPDRS I)scores The Scales for Outcomes in Parkinson’s disease–Autonomic scores(SCOPA-HUT),and the cognitive-related scores in Parkinson’s disease quality of life questionnaire(PDQ-39)were higher in PD patients with RBD,and the Parkinson’s disease sleep scale score was lower,the difference was statistically significant.The incidence of anosmia and constipation in PD+ PRBD group was higher than that in PD-RBD group.Bariate logistic regression analysis was performed on patients,and after adjusting for confounding factors such as age,gender,and course of disease,constipation(OR=3.936,95%CI(1.51,10.263),P =0.005)was a independent risk factor for probable RBD.3.PD-RBD+C group and PD-RBD+C group were compared.The constipation scoring system(CSS)score was higher in PD+ PRBD +C group(10.63±3.75vs8.82±3.414,P =0.042),and the duration of constipation was longer(7(4,10)vs 3(1.75,10),P =0.03),the difference was statistically significant.In addition,patients in the PD+ PRBD +C group were more likely to have constipation in the propathic stage(74.29%vs54.55%,P =0.089),and this difference was not statistically significant.Conclusion: 1.RBD and constipation are common non-motor symptoms in PD patients.2.The equivalent dose of levodopa was higher in PD patients with RBD,and the non-tremor subtype was more common.3.Non-motor symptoms are common in PD patients with RBD,which are easily accompanied by sleep disorders and autonomic nervous dysfunction.In addition,constipation and anosmia are more common in these patients.Such patients are more likely to be affected in terms of quality of life related to cognitive function.4.Constipation is an independent risk factor for RBD,and compared with constipation patients in Parkinson’s disease without RBD,constipation in constipation patients in Parkinson’s disease with RBD is more serious and lasts longer in such patients.