Cognitive Deficits are Similar Among Patients with Serotonergic-induced REM Sleep Behavior Disorder (5-HT RBD) Compared to Idiopathic RBD (iRBD)
Neha Reddy1, Meaghan Berns2, Rachael Berns3, Hannah Olson3, Michael Howell2
1University of Minnesota Medical School, 2Department of Neurology, University of Minnesota, 3independent researcher
Objective:
To describe the prevalence, demographic characteristics, and cognitive function of individuals who believe that selective serotonin reuptake inhibitor (SSRI) use caused or exacerbated symptoms of REM-sleep behavior disorder (RBD) compared to idiopathic RBD (iRBD) in the North American Prodromal Synucleinopathy (NAPS) consortium registry.
Background:
REM-sleep behavior disorder (RBD) is characterized by loss of REM-sleep atonia and recurrent dream enactment behavior and often represents a prodromal neurodegenerative syndrome of alpha-synuclein pathology such as Parkinson’s disease or Lewy body dementia. Among patients with RBD, approximately half are noted to be taking a serotonergic antidepressant. Many patients with RBD indicate that their dream enactment was triggered or exacerbated after they started an SSRI. The exact prevalence of SSRI-induced/exacerbated RBD (5-HT RBD) is not well understood. It is uncertain whether 5-HT RBD is also a prodromal neurodegenerative syndrome, or if individuals with 5-HT RBD are at increased risk for developing neurodegenerative disease in the future.
Design/Methods:
This is a cross-sectional design to examine prevalence, demographic characteristics, and cognitive function of NAPS participants with 5-HT RBD compared to iRBD. Montreal Cognitive assessment (MoCA) scores were used to measure cognitive function. A Kruskal-Wallis statistical test was performed to compare group means.
Results:
Of 294 total participants, 20 identified that an SSRI caused/worsened RBD behaviors. Mean age for the SSRI trigger group was 62.5, 10% were female, and mean MoCA score was 27.3. 159 participants reported never taking an antidepressant. Mean age for this group was 66.9, 10.1% were female, and mean MoCA score was 26.0. There was no significant difference in MoCA scores between the groups.
Conclusions:
Our findings of no significant differences in MoCA scores between the 5HT-RBD and iRBD groups suggest that 5HT-RBD may also represent a prodromal neurodegenerative syndrome. Following these groups prospectively will allow for better insight into their neurological progression.