Comorbidity and medication in REM sleep behavior disorder: A multicenter case-control study

Birgit Frauscher, Poul Jennum, Yo El S Ju, Ronald B. Postuma, Isabelle Arnulf, Valerie Cochen De Cock, Yves Dauvilliers, Maria L. Fantini, Luigi Ferini-Strambi, David Gabelia, Alex Iranzo, Smaranda Leu-Semenescu, Thomas Mitterling, Masayuki Miyamoto, Tomoyuki Miyamoto, Jacques Y. Montplaisir, Wolfgang Oertel, Amélie Pelletier, Paolo Prunetti, Monica PulighedduJoan Santamaria, Karel Sonka, Marcus Unger, Christina Wolfson, Marco Zucconi, Michele Terzaghi, Birgit Högl, Geert Mayer, Raffaele Manni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort. Methods: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis. Results: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95%CI 1.1-3.3; depression: OR 1.6, 95%CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95%CI 2.0-118.8; nonsmoking: OR 2.4, 95%CI 0.4-13.2) and consequent pulmonary disease. Conclusions: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.

Original languageEnglish
Pages (from-to)1076-1079
Number of pages4
JournalNeurology
Volume82
Issue number12
DOIs
Publication statusPublished - Mar 25 2014

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

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