Evidence map›Paper›PMID 33410930›Full record

ReviewJournal of neurology2022

A critical review of the pharmacological treatment of REM sleep behavior disorder in adults: time for more and larger randomized placebo-controlled trials.

Moran Gilat, Nathaniel S Marshall, Dries Testelmans, Bertien Buyse, Simon J G Lewis

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
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  7. Review
  8. Article
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  11. Article
  12. Article
  13. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
  14. Violent behaviour during sleep.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
  15. Multiple system atrophy.Practical neurology · 2023
    Review
  16. Review
  17. Review
  18. Review
  19. Review
  20. REM sleep behaviour disorder: the importance of early identification in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Moran GilatNeurorehabilitation Research Group (eNRGy), Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, 3001, Leuven, Belgium. moran.gilat@kuleuven.be.
Nathaniel S MarshallWoolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
Dries TestelmansCentre for Sleep and Wake Disorders (LUCS), Department of Pneumology, Leuven University, UZ Leuven, Leuven, Belgium.
Bertien BuyseCentre for Sleep and Wake Disorders (LUCS), Department of Pneumology, Leuven University, UZ Leuven, Leuven, Belgium.
Simon J G LewisForefront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, Australia.
KU Leuven · BEUniversity of Sydney · AU

Funding

H2020 Marie Skłodowska-Curie Actions 838576National Health and Medical Research Council 1195830
6 · The paper itself

Abstract

Rapid Eye Movement sleep behavior disorder (RBD) is a parasomnia causing sufferers to physically act out their dreams. These behaviors can disrupt sleep and sometimes lead to injuries in patients and their bed-partners. Clonazepam and melatonin are the first-line pharmacological treatment options for RBD based on direct uncontrolled clinical observations and very limited double-blind placebo-controlled trials. Given the risk for adverse outcomes, especially in older adults, it is of great importance to assess the existing level of evidence for the use of these treatments. In this update, we therefore critically review the clinical and scientific evidence on the pharmacological management of RBD in people aged over 50. We focus on the first-line treatments, and provide an overview of all other alternative pharmacological agents trialed for RBD we could locate as supplementary materials. By amalgamating all clinical observations, our update shows that 66.7% of 1,026 RBD patients reported improvements from clonazepam and 32.9% of 137 RBD patients reported improvements from melatonin treatment on various outcome measures in published accounts. Recently, however, three relatively small randomized placebo-controlled trials did not find these agents to be superior to placebo. Given clonazepam and melatonin are clinically assumed to majorly modify or eliminate RBD in nearly all patients-there is an urgent need to test whether this magnitude of treatment effect remains intact in larger placebo-controlled trials.

Indexed as

MelatoninREM Sleep Behavior DisorderSleep Wake DisordersAgedClonazepamDouble-Blind MethodHumansRandomized Controlled Trials as TopicClonazepamMelatoninBenzodiazepinesCircadinDrugsLewy body dementiaMultiple system atrophyParkinson’s diseasePharmacotherapy

Identifiers

PMID33410930
PMCPMC8739295
OpenAlexW3120953896

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.