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In this cohort study, the investigators aim to study the familial aggregation of REM sleep behavior disorder (RBD) and compare the differences in major biomarkers of neurodegeneration, including percentage of EMG activity during REM sleep, cognitive functions, autonomic dysfunction, and psychiatric disorders, between unaffected first degree relatives of RBD cases and non-RBD controls.
REM sleep behavior disorder (RBD) is a parasomnia characterized by abnormal behavioral manifestations during REM sleep. Previous case-control studies and prospective studies have documented the progression of α-synucleinopathy neurodegeneration in relation to RBD and have identified some biomarkers of predicting neurodegeneration in patients with iRBD, such as olfactory dysfunction, color vision deficit, autonomic dysfunction, tonic EMG activity during REM sleep, and psychiatric disorder. However, these biomarkers might precede the onset of RBD, as a result, searching for biomarkers for the neurodegeneration before RBD onset is helpful to map the progression of neurodegeneration. In this regard, the investigators aim to study the familial aggregation of RBD and its core features, and compare the differences in major biomarkers of neurodegeneration, including percentage of EMG activity during REM sleep, cognitive functions, autonomic dysfunction, and psychiatric disorders, between unaffected first degree relatives of RBD cases and non-RBD controls.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FDRs of RBD cases | FDRs of RBD cases. The diagnosis of RBD is based on ICSD-II criteria, as confirmed by v-PSG and with the aid of REM sleep behaviour disorder questionnaire (RBDQ-HK). RBD cases which are secondary to narcolepsy, neurodegenerative diseases or other neurological diseases are excluded. | ||
| FDRs of non-RBD controls | FDRs of non-RBD controls. Non-RBD control probands are free of narcolepsy, significant clinical RBD symptoms and other neurological diseases. |
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| Measure | Description | Time Frame |
|---|---|---|
| The prevalence rate of probable RBD among first degree relatives of RBD probands | The prevalence rate of probable RBD based on the self-reported/proxy-reported RBD symptoms in RBDQ-HK among first degree relatives of RBD probands in comparison to that of first degree relatives of controls. | 15 minutes |
| The weighted prevalence rate of confirmed RBD among first degree relatives of RBD probands. | The weighted prevalence rate of first degree relatives meeting full ICSD-II2 diagnostic criteria for RBD confirmed by clinical history and vPSG. | one night (8 hours) |
| Measure | Description | Time Frame |
|---|---|---|
| The percentage of REM-related EMG activity (REMREEA) | The percentage of REM-related EMG activity (REMREEA) is the most reliable and valid marker in differentiating patients with RBD from normal controls. Basically, the REMREEA include two components, namely phasic EMG activity and tonic EMG activity, respectively. The phasic EMG events were defined as any burst of EMG activity lasting 0.1 to 5 sec with amplitude > 4 times the background EMG activity and will be score on the basis of 3-second mini-epoch during REM sleep. Each 30-sec epoch during REM sleep was scored as tonic or atonic depending on whether tonic chin EMG activity was present for more or less than 50% of the epoch. The total EMG activity was presented as the percentage of REM related EMG activity (REMREEA) with the percentage of tonic EMG activity plus the percentage of phasic EMG activity. |
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Inclusion Criteria:
Exclusion Criteria:
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We established a case-control cohort of RBD with regular follow-ups and we have now accumulated over 280 RBD cases and age-sex matched controls. Proband of RBD and non-RBD controls will be recruited from this cohort. The control probands were initially recruited from the community and clinical samples (those with other sleep disorders such as obstructive sleep apnea syndrome) that did not have RBD as confirmed by clinical and vPSG assessments.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jihui Zhang, PhD | Contact | (852) 39197647 | jihui.zhang@cuhk.edu.hk |
| Name | Affiliation | Role |
|---|---|---|
| Jihui Zhang, PhD | Chinese University of Hong Kong | Principal Investigator |
| Yun Kwok Wing, MBChB | Chinese University of Hong Kong | Study Director |
| Siuping LAM |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of psychiatry, Faculty of Medicine, The Chinese University of Hong Kong | Recruiting | Hong Kong | Hong Kong |
In this stage, we didn't decide which information of IPD will share with other researchers.
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| ID | Term |
|---|---|
| D020187 | REM Sleep Behavior Disorder |
| ID | Term |
|---|---|
| D020923 | REM Sleep Parasomnias |
| D020447 | Parasomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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TFT-SEP Serum Clot, Vitamin B12-SEP Serum clot, Folate- SEP Serum clot, CBC-EDTA, Fasting Glucose-Fluoride
| one night (8 hours) |
| Significant motor activity | Significant motor activity were recorded by video-polysomnography. The motor analysis will be scored according to the previously established method. In view of the potential problem in inter-rater reliability in those mild motor activities, we will only include those complex activities and vocalizations in the analyses. It has been shown that there are large differences in the significant motor activities between patients with RBD and normal controls. In view of the relatively high night-to-night variability and low inter-rater reliability in scoring motor activity, it will be considered as secondary outcome. | one night (8 hours) |
| Other biomarkers of RBD in the first degree relatives of RBD patients. | Previous studies have also confirmed that RBD patients present with autonomic dysfunction, olfactory dysfunction, color vision deficit, neurocognitive function, and a higher rate of psychiatric disorders, these markers will also be considered as secondary biomarkers and will be compared in the first degree relatives of between patients and controls. | 2 hours |
| Chinese University of Hong Kong |
| Study Director |
| Vicent Chung-tong MOK | Chinese University of Hong Kong | Study Director |
| D001523 |
| Mental Disorders |