Objective:

The goal of this study is to evaluate one-year outcomes of rapid eye movement (REM) sleep behavior disorder (RBD) in a cohort of patients with Parkinson’s disease (PD) who underwent deep brain stimulation (DBS) at globus pallidus interna (GPi).

Background:

REM Sleep Behavior Disorder (RBD) is a parasomnia involving dream enactment and loss of atonia during REM. Over 50% of patients with PD suffer from RBD. DBS is used to treat motor fluctuations associated with PD, however, little is known about the effect of DBS on nonmotor symptoms such as RBD.

Design/Methods:

Patients with PD who underwent GPi DBS were surveyed at baseline and 12 months using the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) to determine the presence and severity of RBD (RBDSQ ≥ 5). The results were analyzed using a paired t-test. Medications were assessed for possible confounding factors affecting RBD.

Results:

Out of 12 patients, eight were found to have RBD at baseline. There was no significant change in RBDSQ scores in this cohort one year after DBS (p=0.71). Of those with RBD at baseline, there was a significant decrease in RBDSQ scores one year after DBS (p<0.001). Possible confounding medications changed at one year for five patients, three of which had RBD at both baseline and one year. One patient who had resolution of RBD at one year discontinued use of selective serotonin reuptake inhibitors.

Conclusions:

This study suggests that GPi DBS may have a statistically significant effect on RBD in patients with PD. Most RBDSQ scores decreased between one and three points by one year. This may suggest that GPi is connected to the circuitry that regulates REM sleep. Future studies with a larger cohort are needed to evaluate the longitudinal effects of GPi DBS as stimulation is optimized.