Joza Stephen, Iranzo Alex, Stefani Ambra, Pelletier Amelie, Serradell Monica, Muñoz-Lopetegi Amaia, Ibrahim Abubaker, Holzknecht Evi, Montplaisir Jacques Y, Mayà Gerard, Santamaria Joan, Gaig Carles, Bergmann Melanie, Brandauer Elisabeth, Högl Birgit, Gagnon Jean-François, Postuma Ronald B
Montreal Neurological Institute McGill University Montreal Quebec Canada.
Neurology Service, Sleep Disorders Center Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERNED Barcelona Spain.
Mov Disord Clin Pract. 2023 Aug 7;10(10):1519-1524. doi: 10.1002/mdc3.13842. eCollection 2023 Oct.
Since 2014, there has been increasing public outreach effort regarding isolated/idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) in Montreal.
To assess if, over time, milder iRBD cases are presenting earlier.
Disease-free survival was compared in two iRBD recruitment epochs: 2004 to 2013 ("earlier") versus 2014to 2022 ("later) and by referral type ("self-referral" vs. "conventional-referral") in three large centers.
In Montreal, among 209 subjects followed prospectively, shorter time to phenoconversion was observed in the earlier epoch (5-year phenoconversion = 42% earlier vs. 23% later); diagnosis before 2014 had a 1.8-fold phenoconversion hazard. However, no difference was observed in 248 subjects from Barcelona and 166 from Innsbruck. Analysis of Montreal data found that increased survival in the later epoch was driven by an increasing number of self-referrals, who phenoconverted at 1/3 the rate of physician-referred subjects.
Increased patient awareness of iRBD results in earlier presentation to clinical attention, with a longer time to phenoconversion.
自2014年以来，蒙特利尔针对孤立性/特发性快速眼动（REM）睡眠行为障碍（iRBD）开展的公众宣传工作日益增多。
评估随着时间推移，病情较轻的iRBD病例是否更早出现。
在三个大型中心比较了两个iRBD招募阶段的无病生存期：2004年至2013年（“早期”）与2014年至2022年（“后期”），并按转诊类型（“自我转诊”与“传统转诊”）进行比较。
在蒙特利尔，对209名受试者进行前瞻性随访，早期阶段观察到症状转化时间较短（5年症状转化率：早期为42%，后期为23%）；2014年前诊断的患者症状转化风险是后者的1.8倍。然而，在巴塞罗那的248名受试者和因斯布鲁克的166名受试者中未观察到差异。对蒙特利尔数据的分析发现，后期阶段生存期的延长是由自我转诊人数增加推动的，这些患者的症状转化率是医生转诊患者的三分之一。
患者对iRBD的认识提高导致其更早引起临床关注，症状转化时间更长。
