BACKGROUND AND OBJECTIVES Isolated REM sleep behavior disorder (iRBD) is strongly associated with synucleinopathies. Previous iRBD cohort studies have primarily focused on older (>50 years), male-predominant cohorts. Risk of phenoconversion in women and younger adults remains unclear. The study aimed to determine clinical features associated with conversion to a defined neurodegenerative disorder in women and men with iRBD. METHODS One hundred eighty-six women and 186 men with iRBD were matched by polysomnography month. Baseline clinical variables and subsequent neurodegenerative outcomes were abstracted by chart review. Kaplan-Meier curves assessed conversion rates. Cox proportional hazards modeling evaluated factors associated with phenoconversion risk. RESULTS Age at iRBD diagnosis was younger in women compared with men (54.9 vs 62.5 years, p < 0.01). Forty-eight patients (12.9%), including 18 women (9.7%) and 30 men (16.1%), phenoconverted during a median follow-up of 6.0 years. Conversion rates were lower in antidepressant users and patients with chronic pain or psychiatric comorbidity while rates were higher in those with vascular comorbidity. Only age at diagnosis (HR 1.09, 95% CI 1.06-1.13) was associated with phenoconversion after adjusting for RBD symptom duration; sex; antidepressant use; and psychiatric, chronic pain, and vascular comorbidities. DISCUSSION Age at diagnosis was independently associated with phenoconversion risk in women and men with iRBD.

中文翻译：

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孤立性 REM 睡眠行为障碍女性和男性的表型转换：一项回顾性队列研究。


背景和目的 孤立性 REM 睡眠行为障碍 （iRBD） 与突触核蛋白病密切相关。以前的 iRBD 队列研究主要集中在年龄较大 （>50 岁）、以男性为主的队列上。女性和年轻人发生表型转换的风险仍不清楚。该研究旨在确定患有 iRBD 的女性和男性与转化为明确的神经退行性疾病相关的临床特征。方法 186 例 iRBD 女性和 186 例男性通过多导睡眠图月进行匹配。通过图表审查提取基线临床变量和随后的神经退行性结局。Kaplan-Meier 曲线评估转化率。Cox 比例风险模型评估了与表型转换风险相关的因素。结果 与男性相比，女性诊断 iRBD 的年龄更年轻 （54.9 vs 62.5 岁，p < 0.01）。48 例患者 （12.9%），包括 18 例女性 （9.7%） 和 30 例男性 （16.1%），在中位随访 6.0 年期间发生了表型转化。抗抑郁药使用者和慢性疼痛或精神合并症患者的转化率较低，而血管合并症患者的转化率较高。在调整 RBD 症状持续时间后，只有诊断年龄 （HR 1.09,95% CI 1.06-1.13） 与表型转换相关;性;使用抗抑郁药;以及精神、慢性疼痛和血管合并症。讨论 诊断年龄与 iRBD 女性和男性的表型转换风险独立相关。