Open AccessPredicting neurodegenerative disease in idiopathic rapid eye movement (REM) sleep behavior disorder: Conference proceedings, REM Sleep Behavior Symposium 2011
Author(s) -
Postuma Ronald B
Publication year - 2013
Publication title -
sleep and biological rhythms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 30
eISSN - 1479-8425
pISSN - 1446-9235
DOI - 10.1111/j.1479-8425.2012.00557.x
Subject(s) - rem sleep behavior disorder , parasomnia , neurodegeneration , dementia with lewy bodies , rapid eye movement sleep , neuroscience , parkinson's disease , neurology , medicine , disease , parkinsonism , dementia , hyposmia , substantia nigra , neuroprotection , prodromal stage , psychology , polysomnography , eye movement , pathology , electroencephalography , covid-19 , infectious disease (medical specialty)
Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment behavior during rapid eye movement sleep, which is generally related to damage of pontomedullary structures. Idiopathic RBD is a well‐established risk factor for neurodegenerative disease; at least 40–65% of patients with idiopathic RBD will develop a defined neurodegenerative phenotype over 10 years. This is almost always a “synucleinopathy” (Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy). Often, patients develop a syndrome with overlapping parkinsonism and cognitive impairment. The ability of RBD to predict disease has major implications for development of neuroprotective therapy, by providing a high‐risk prodromal group for neuroprotective trials. In addition, it allows testing of other predictive markers of neurodegeneration. Recent prospective studies found that idiopathic RBD patients with abnormal olfaction at baseline had a 65% 5‐year risk of developing neurodegenerative disease, compared with a 14% risk in those with normal olfaction. Those with abnormal color vision had a 74% risk of neurodegenerative disease compared with 26% in those with normal vision. Additionally, neuroimaging markers of the substantia nigra including dopaminergic functional imaging and transcranial ultrasound have been able to predict imminent development of defined neurodegenerative disease in RBD, although sensitivity and lead time have not been established. Future studies will continue to expand the list of predictive markers of neurodegeneration and will better define specificity, sensitivity, and lead time of prodromal markers.