Olfactory Function And Sleep Architecture In Parkinson’s Disease With Rapid Eye Movement Sleep Behavior Disorder

Objective: Olfactory dysfunction and REM sleep behavior disorder(RBD) are common symptoms in patients with Parkinson’s disease(PD). To explore the impact of RBD on multiple non-motor symptoms(NMS) in PD patients, we evaluated their olfactory and sleep structure,andanalyze the correlation between sleep structure and olfactory function in PD patients with RBD.Methods:We evaluated olfactory function by the T&T olfactory assessment and conducted overnight polysomnography in 4 groups of subjects: i RBD, PD-RBD, PD+RBD, and controls. A logistic regression analysis was performed to evaluate the association between olfaction and(the onset) of RBD.Results:(1)Compared with the controls(0.66±0.55,1.54±0.55), i RBD group(1.66±0.73,2.51±0.83), PD-RBD group(1.69±1.19,2.49±1.097) and PD+RBD group(2.2821±1.08,3.0564±0.96) showed significantly higher olfactory detection scores(P<0.05, P<0.05, P< 0.01), and identification scores(P< 0.01, P< 0.01, P< 0.01).Compared with the PD+RBD group, PD group showed decreased detection scores(P< 0.05) and identification scores(P< 0.01).(2)Compared with i RBD group, patients with PD+RBD group and PD-RBD group had a higher scores of UPDRS I(P<0.05,P<0.05), UPDRS II(P<0.05,P<0.05), UPDRS III(P<0.05,P<0.05).Compared with PD-RBD group, PD +RBD group had higher UPDRS III scores(P<0.05), higher LED(P<0.01) and PQSI(P<0.05), and lower Mo CA scores(P<0.05).(3)Compared to healthy control,i RBD patients,PD-RBD patients, PD+RBD patients showed longer sleep latency, worse sleep efficiency,and higer spontaneous arousal index; PD-RBD patients, PD+RBD patients were showed more stage II sleep and less REM sleep.Compared to PD patients,i RBD patients and PD+RBD patients showed higer spontaneous arousal,PD+RBD patients more likely to have worse sleep efficiency.(4)This analysis revealed that the presence of RBD [odds ratio(OR) = 22.383, 95% confidence interval(CI) = 2.854-175.547, P= 0.003), the score of MMSE(OR = 0.566, 95% CI = 0.338-0.948, P= 0.031) were significantly associated with the presence of olfactory dysfunction. PD patients olfactory dysfunction correlated with the onset of RBD and cognitive function.Conclusions: RBD and PD(with or without RBD) patients are more likely to have olfactory dysfunction and sleep disorder.RBD has obvious influence on PD olfactory and sleep.