Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Feb;22(2):93-104.
doi: 10.1007/s11910-022-01171-0. Epub 2022 Mar 11.

Predictors of RBD progression and conversion to synucleinopathies

Edoardo Rosario de Natale #  1 , Heather Wilson #  1 , Marios Politis  2
Affiliations
Review

Predictors of RBD progression and conversion to synucleinopathies

Edoardo Rosario de Natale et al. Curr Neurol Neurosci Rep. 2022 Feb.

Abstract

Purpose of review: Rapid eye movement (REM) sleep behaviour disorder (RBD) is considered the expression of the initial neurodegenerative process underlying synucleinopathies and constitutes the most important marker of their prodromal phase. This article reviews recent research from longitudinal research studies in isolated RBD (iRBD) aiming to describe the most promising progression biomarkers of iRBD and to delineate the current knowledge on the level of prediction of future outcome in iRBD patients at diagnosis.

Recent findings: Longitudinal studies revealed the potential value of a variety of biomarkers, including clinical markers of motor, autonomic, cognitive, and olfactory symptoms, neurophysiological markers such as REM sleep without atonia and electroencephalography, genetic and epigenetic markers, cerebrospinal fluid and serum markers, and neuroimaging markers to track the progression and predict phenoconversion. To-date the most promising neuroimaging biomarker in iRBD to aid the prediction of phenoconversion is striatal presynaptic striatal dopaminergic dysfunction. There is a variety of potential biomarkers for monitoring disease progression and predicting iRBD conversion into synucleinopathies. A combined multimodal biomarker model could offer a more sensitive and specific tool. Further longitudinal studies are warranted to iRBD as a high-risk population for early neuroprotective interventions and disease-modifying therapies.

Keywords: Biomarkers; Rapid eye movement sleep behaviour disorder; Synucleinopathies.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Schematic summary of the main areas of biological alterations found in association with increased rate of progression and/or phenoconversion of iRBD patients to synucleinopathy. Abbreviations: EEG: electroencephalogram; GBA: glucocerebrosidase; REM: rapid eye movements; SNCA: synuclein; TMEM175: transmembrane protein 175
See this image and copyright information in PMC

References

    1. Dauvilliers Y, Schenck CH, Postuma RB, Iranzo A, Luppi PH, Plazzi G, et al. REM sleep behaviour disorder. Nat Rev Dis Primers. 2018;4(1):19. doi: 10.1038/s41572-018-0016-5. - DOI - PubMed
    1. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146(5):1387–1394. doi: 10.1378/chest.14-0970. - DOI - PubMed
    1. Cicero CE, Giuliano L, Luna J, Zappia M, Preux PM, Nicoletti A. Prevalence of idiopathic REM behavior disorder: a systematic review and meta-analysis. Sleep. 2021;44(6). doi:10.1093/sleep/zsaa294. - PubMed
    1. Iranzo A, Santamaria J, Tolosa E. Idiopathic rapid eye movement sleep behaviour disorder: diagnosis, management, and the need for neuroprotective interventions. Lancet Neurol. 2016;15(4):405–419. doi: 10.1016/S1474-4422(16)00057-0. - DOI - PubMed
    1. Berg D, Borghammer P, Fereshtehnejad SM, Heinzel S, Horsager J, Schaeffer E, et al. Prodromal Parkinson disease subtypes - key to understanding heterogeneity. Nat Rev Neurol. 2021;17(6):349–361. doi: 10.1038/s41582-021-00486-9. - DOI - PubMed