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Biomarkers of Neurodegenerative Disease in Idiopathic RBD

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Rapid-Eye-Movement Sleep Behavior Disorder

Abstract

Arguably the most important implication of the discovery of RBD is that it is associated with a very high risk of neurodegeneration. The longest-term studies suggest that >80% of patients convert to defined neurodegenerative synucleinopathy. This provides a notable opportunity to directly assess prodromal markers of disease, in order to test predictive value and observe evolution of prodromal states. It is clear that many markers, including olfaction, subtle motor abnormalities, color vision, electroencephalography, and SPECT/PET scanning, can identify patients at higher risk of neurodegeneration. By contrast, the predictive value of other sleep abnormalities, depression, personality changes, and substantia nigra ultrasound is less clear, at least within idiopathic RBD itself. Now that patients can be reliably stratified for neurodegenerative disease risk, the time has come to start neuroprotective trials against neurodegeneration in RBD.

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Note Added in Proof:

The following is a pertinent recent study: Mondello S, Kobeissy F, Mechref Y, et al. Novel biomarker signatures for idiopathic REM sleep behavior disorder: a proteomic and system biology approach. Neurology 2018. (in press).

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  1. Department of Neurology, McGill University, Montreal General Hospital, Montreal, QC, Canada

    Ronald B. Postuma

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Correspondence to Ronald B. Postuma .

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Editors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, MN, USA

    Carlos H. Schenck

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

  3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Aleksandar Videnovic

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Postuma, R.B. (2019). Biomarkers of Neurodegenerative Disease in Idiopathic RBD. In: Schenck, C., Högl, B., Videnovic, A. (eds) Rapid-Eye-Movement Sleep Behavior Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-90152-7_36

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