期刊
NEUROLOGIST
卷 13, 期 2, 页码 98-101出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.nrl.0000257848.06462.46
关键词
REM sleep behavior disorder; synucleinopathy; Parkinson disease; dementia with Lewy bodies; multiple system atrophy; prognosis; evidence-based medicine
Objective: To determine whether a diagnosis of idiopathic rapid-eye-movement sleep behavior disorder (RBD) is associated with a future risk of development of neurodegenerative diseases. Methods: We addressed the objective through development of a structured critically appraised topic that included a clinical scenario, structured question, search strategy, critical appraisal, results, summary of best evidence, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, clinical epidemiologists, medical librarians, and clinical content experts. Results: A retrospective study of 44 consecutive patients diagnosed with idiopathic RBD demonstrated that 20 patients (45%) developed a neurologic disorder, most commonly Parkinson disease or Lewy body dementia, after a mean of 11.5 years from reported symptom onset and 5.1 years after RBD diagnosis. Conclusion: Currently available evidence is limited to cross-sectional and retrospective analyses of patients with RBD. Although ascertainment biases and the retrospective nature of the available evidence limits quantitative analyses, the diagnosis of idiopathic RBD portends a risk of greater than 45% for future development of a clinically defined neurodegenerative disease. This finding has significant implications for clinical neurologic and sleep disorder practice and neurodegenerative disease research.
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