Non-Motor symptoms in prodromal Parkinson’s disease are linked to reduced Quality of Life

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Background Isolated REM sleep behavior disorder (iRBD) is the most specific prodromal marker of Parkinson’s disease (PD), often accompanied by various non-motor symptoms. In PD, non-motor symptoms are strongly associated with reduced health-related quality of life (hrQoL). Objectives To identify factors linked to poorer hrQoL in patients with iRBD and to compare their hrQoL to healthy control participants (HC) and patients with PD. Methods Sixty-two patients with iRBD ( M = 66.44±6.14), 29 patients with PD ( M = 67.21±7.23), and 19 HC ( M = 67.57±8.16) were included. We administered the 36-Item Short Form Health Survey (SF-36) to assess hrQoL. Additionally, participants underwent a comprehensive clinical evaluation of non-motor symptoms. Results The SF-36 total score was significantly lower in patients with iRBD (83.33±16.96) compared to HC (92.29±5.49, U = 390.00, Z = −2.218, p = .027, r = 0.246). Poorer hrQoL in patients with iRBD was linked to self-reported neuropsychiatric symptoms, sleep-wake disturbances, and a higher burden of autonomic symptoms (all r = -.25 to -.76, all p < .05). Multiple regression analysis revealed fatigue and depressive symptoms as significant predictors of poorer hrQoL in patients with iRBD ( F (5.56) = 51.59, p < .001, adjusted R 2 = 0.81). Conclusions This study highlights the importance of non-motor symptoms for hrQoL in prodromal PD, irrespective of motor symptoms. Fatigue and depressive symptoms arise as the most relevant therapeutic targets in the prodromal stage of PD to optimize the patient’s quality of life.