REM Sleep Behavior Disorder Increases the Risk of Lower Urinary Tract Symptoms in PD Patients: A Study Based on the Long-term Follow-up Database of Parkinson's disease

Abstract Objective: To investigate the association between lower urinary tract symptoms (LUTS), Parkinson's disease (PD) progression, and the presence of REM sleep behavior disorder (RBD) in PD patients. Methods: A total of 897 PD patients from the Long-term follow-up database of Parkinson's disease (LEAD-PD) were included in the study. The prevalence of LUTS and its association with RBD, non-motor symptoms, and disease severity were analyzed. Intergroup comparisons, subgroup analysis, logistic regression and ROC curve analyses were used to identify clinical features associated with LUTS. Results: LUTS is common in patients with PD, with nocturia being the most frequent symptom. LUTS is correlated with disease severity (UPDRS I to IV, p<0.001), cognitive function (MMSE, p<0.001), depression (HRSD, p<0.001), and quality of life (PDQ39, p<0.001). The presence of RBD significantly increased the occurrence of LUTS, particularly urinary urgency (p<0.001) and frequency (p<0.001), in both male and female PD patients. RBD combined with non-motor symptom scores (NMSQ), UPDRS I or quality of life scores (PDQ39) served as a highly sensitive predictor for the onset of urinary urgency (AUC=0.881) and frequency (AUC=0.915) in PD patients. Conclusion: RBD is an independent risk factor for LUTS in patients with PD. it is crucial to strengthen the prevention and treatment of LUTS symptoms in PD-RBD patients. Further research exploring the pathological and physiological mechanisms by which RBD leads to LUTS symptoms can provide a deeper understanding of the occurrence and progression of PD, paving the way for the development of innovative treatments.