Meta Analysis About Factors Related To REM Sleep Behavior Disorder In Parkinson Disease

Objective:Researches demonstrates that REM sleep behavior disorder (RBD) should be considered an integral part of neurodegenerative diseases, especially synucleinopathies, such as Parkinson disease (PD), and maybe the first manifestation of these diseases. But not all PD patients have RBD. The absence of RBD in a certain proportion of PD patients, even in advanced stages, indicates that various factors other than brainstem nuclei degeneration might be associated with the presence of RBD in PD patient, and PD with RBD may results from a different underlying pattern of neurodegeneration than PD without RBD. A number of studies have investigated factors associated with the presence of RBD in PD patients, but these studies have failed to provide consistent results, presumably because of a limited number of study subjects and the different types of clinical variables investigated in each study. Therefore, we performed this Meta analysis about factors related to REM sleep behavior disorder in PD by integrating all related studies and increasing study subjects, in order to find out the precise relationship between RBD and PD.Methods:Selection of literature was accomplished by searching the PubMed database of the National Center for Biotechnology Information (NCBI) using the keywords "REM sleep behavior disorder", "Rapid eye movement sleep behavior disorder". All references cited in articles on association analyses, reviews and/or Meta analyses were examined to identify potential additional studies not revealed by searching the PubMed. We performed Meta analysis through Revman4.2. Results:Meta analysis demonstrates that PD patients with RBD have a longer PD duration, a higher Hoehn & Yahr stage, a higher UPDRS partâ…¢score, more male, dyskinesia, hallucination, postural hypotension and constipation than PD patients without RBD. Patients'age, PD onset age, Levodopa equilibrium dose,Levodopa dose,Levodopa duration. wearing-off,depression score (BDI),MMSE score and restless leg syndrome have no significant differences between PD patients with or without RBD.Conclusion:A longer PD duration and more severe disability are associated with the presence of RBD in PD patients. PD patients with RBD have more non-motor symptoms, such as autonomic disorders and hallucination, which indicates that PD patients with RBD have more severe and widespread degenerative changes in the central nervous system than those without RBD.