Rapid eye movement sleep behavior disorder (RBD) is associated with cognitive decline in early Parkinson’s disease (PD). However, the underlyling basis for this association remains unclear. Parkinson’s Progression Marker’s Initiative (PPMI) subjects underwent baseline RBD testing with RBD sleep questionnaire (RBDSQ). Serial assessments included measures of motor symptoms, non-motor symptoms (NMS), neuropsychological assessment, blood and cerebrospinal fluid (CSF) biomarkers. Up to three years follow-up data were included. We stratified early PD subjects into PD with RBD (RBDSQ score > 5) and PD without RBD groups. Then, we evaluated baseline biomarkers in each group as a predictor of cognitive decline using Montreal Cognitive Assessment (MoCA) score changes over three years in regression models. Four hundred twenty-three PD subjects were enrolled at baseline, and a total of 350 PD subjects had completed 3 years of study follow-up with completely serial assessments. We found that at baseline, only CSF β-amyloid 1–42 (Aβ1–42) was significantly lower in PD subjects with RBD. On three years follow-up analysis, PD subjects with RBD were more likely to develop incident mild cognitive impairment (MCI) and presented greater cognitive decline in MoCA score. Lower baseline CSF Aβ1–42 predicted cognitive decline over 3 years only in PD subjects with RBD (β = − 0.03, P = 0.003). A significant interaction between Aβ1–42 and the 2 groups confirmed that this effect was indeed higher in PD with RBD than the other individual (β = − 2.85, P = 0.014). These findings indicate that CSF Aβ1–42 level is associated with global cognitive decline in early PD with RBD. The addition of CSF Aβ1–42 to RBD testing increase the likelihood of identifying those at high risk for cognitive decline in early PD.

中文翻译：

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脑脊液 Aβ1-42 水平与早期帕金森病伴快速眼动睡眠行为障碍的认知能力下降有关

快速眼动睡眠行为障碍 (RBD) 与早期帕金森病 (PD) 的认知能力下降有关。然而，这种关联的根本基础仍不清楚。帕金森病进展标记倡议 (PPMI) 受试者使用 RBD 睡眠问卷 (RBDSQ) 进行基线 RBD 测试。系列评估包括运动症状、非运动症状 (NMS)、神经心理学评估、血液和脑脊液 (CSF) 生物标志物的测量。包括长达三年的随访数据。我们将早期 PD 受试者分层为具有 RBD 的 PD（RBDSQ 评分 > 5）和没有 RBD 组的 PD。然后，我们在回归模型中使用蒙特利尔认知评估 (MoCA) 评分变化三年来评估每组中的基线生物标志物作为认知衰退的预测因子。基线时招募了 423 名 PD 受试者，共有 350 名 PD 受试者完成了 3 年的研究随访，并进行了完整的系列评估。我们发现，在基线时，只有 CSF β-淀粉样蛋白 1-42 (Aβ1-42) 在患有 RBD 的 PD 受试者中显着降低。在三年的随访分析中，患有 RBD 的 PD 受试者更有可能发生轻度认知障碍 (MCI)，并且在 MoCA 评分中表现出更大的认知下降。较低的基线 CSF Aβ1-42 仅在患有 RBD 的 PD 受试者中预测 3 年内的认知能力下降（β = - 0.03，P = 0.003）。Aβ1-42 和 2 组之间的显着相互作用证实，这种效应在 RBD 的 PD 中确实高于其他个体（β = - 2.85，P = 0.014）。这些发现表明 CSF Aβ1-42 水平与早期 PD 伴 RBD 的整体认知能力下降有关。在 RBD 测试中添加 CSF Aβ1-42 增加了识别早期 PD 认知衰退高风险人群的可能性。