Assessing Veterans With Gulf War Illness for Prodromal Parkinson's Disease Risk With the REM Behavioral Sleep Disorder Questionnaire.

Abstract

To assess deployed Gulf War (GW) veterans for prodromal Parkinson's Disease (PD) using the REM Sleep Behavioral Disorder (RBD) Screening Questionnaire (RBDSQ). GW veterans ( n = 165) were assessed for nonmotor PD symptoms with the RBDSQ, Non-Motor Symptoms Scale, and Scales for Outcomes in Parkinson's Disease-Autonomic. Some veterans were also assessed with the University of Pennsylvania Smell Identification Test ( n = 120), neurological examinations ( n = 41), and 3T magnetic resonance imaging ( n = 16). Eighty percent of veterans with PD and 73% of veterans without PD had probable RBD (ie, RBDSQ ≥5). Exploratory analysis conducted for hypothesis-generating purposes revealed that RBDSQ scores were positively associated with GW deployment-related exposures and inversely associated with brainstem volume. These findings suggest that veterans with GWI and high levels of deployment-related exposures are at risk for prodromal PD, possibly through RBD as a mediator.