关键词: 帕金森病, REM睡眠行为障碍, 痴呆, 疾病特征

Abstract: Background　Rapid eye movement（REM） sleep behavior disorder（RBD） is important not only as a preclinical symptom but also an aggravating symptom of Parkinson's disease（PD）.However，it is not known whether the onset of RBD in relation to PD affects the clinical characteristics of PD.Objective　To study the clinical characteristics of PD between patients with RBD occurring before and after the onset of PD.Methods　Participants were recruited from Dalian Friendship Hospital between October 2013 and May 2018，including 136 PD patients from Department of Neurology，and 30 volunteered health examinees with normal cognitive function（control group） from the Physical Examination Center.Descriptive variables including age，sex ratio，dose of dopaminergic agents〔levodopa dose equivalents（LEDs）〕，duration of PD morbidity，Hoehn and Yahr stage，prevalence of tremor，laterality of PD symptoms，Mini-Mental State Examination（MMSE） score，prevalence of OH，self-reported hallucinations，and dementia were compared across PD patients with and without RBD and controls，and across PD patients with RBD before and after the onset of PD and controls.Results　PD patients included 47 with RBD（consisting of 9 with RBD before the onset of PD，and 38 with RBD after the onset of PD） and 89 without RBD.Those with RBD had longer mean duration of PD morbidity，higher prevalence of advanced Hoehn-Yahr stages，using greater dosage of LEDs，hallucinations，OH，and dementia，and lower mean MMSE score than those without RBD（P<0.05）.PD patients with RBD had higher prevalence of hallucination，OH and dementia than the controls，and so did PD patients without RBD（P<0.05）.PD patients with RBD before the onset of PD had lower mean MMSE score and higher prevalence of dementia than those with RBD after the onset of PD（P<0.05）.The mean MMSE score was lower and the prevalence of dementia was greater in PD patients with RBD before or after the onset of PD compared to controls（P<0.05）.Conclusion　The occurrence of RBD after the onset of PD might be an important factor aggravating cognitive function.

Key words: Parkinson disease, REM sleep behavior disorder, Dementia, Disease attributes