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
. 2025 Jun 17;272(7):466.
doi: 10.1007/s00415-025-13195-w.

"How to save a marriage": treatment of REM sleep behavior disorder (RBD) with acetyl-leucine in a patient with Parkinson's disease

Wolfgang H Oertel #  1   2 , Martin T Henrich #  3   4 , Filip Bergquist  5   6 , Annette Janzen  3 , Fanni F Geibl #  3   4 , Michael Strupp #  7
Affiliations

"How to save a marriage": treatment of REM sleep behavior disorder (RBD) with acetyl-leucine in a patient with Parkinson's disease

Wolfgang H Oertel et al. J Neurol. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: This single case observational study has been conducted with the drug TanganilR. This drug contains the racemate acetyl-DL-leucine, i.e., to equal parts the bio-inactive substance acetyl-D-leucine and the bioactive enantiomer acetyl-L-leucine. This drug is produced by the company Pierre Fabre, Medicaments, France and approved for the indication vertigo in France. The company Pierre Fabre was not aware of our observational study as none of the authors had any contact during and after the conduct of the study with the company. Wolfgang Oertel (WO) and Michael Strupp (MS) are members of the scientific advisory board of the company IntraBio. WO holds stock options of the company IntraBio, whereas MS is an investor and shareholder of the company Intrabio. In addition, we declare that neither the company Pierre Fabre nor the company IntraBio have supported the conduct of the case report submitted with this article by any means. Wolfgang H. Oertel also acts as a consultant for the company MODAG. He holds stock options with MODAG unrelated to this work. The institution of W.H.O., not W.H.O personally received/s scientific grants from the ParkinsonFonds Deutschland related to the manuscript and from the German Research Foundation, Stichting Parkinson-Fonds, The Netherlands and the Michael J Fox Foundation, USA, all unrelated to the manuscript. Martin T. Henrich has no conflict of interest to declare. Filip Bergquist has no conflict of interest to declare. Annette Janzen has no conflict of interest to declare. Fanni F. Geibl has no conflict of interest to declare. Michael Strupp is Joint Chief Editor of the Journal of Neurology, Editor in Chief of Frontiers of Neuro-otology and Section Editor of F1000. He acts as a consultant for Abbott, AurisMedical, Bulbitec, Heel, Sensorion and Vertify. The institution of M.S., not M.S. personally received/s support for clinical studies from Decibel, U.S.A., Cure within Reach, U.S.A. and Heel, Germany. Ethical standard: Supplementary Material for ethical considerations.

Figures

Fig. 1
Fig. 1
Photographs of the bedroom before (a) and under therapy (b) with acetyl-leucine
Fig. 2
Fig. 2
7-day-RBD_severity sum-score (7d-RBD_SS) during acetyl-leucine therapy and washout phases. After 4 weeks of AL therapy, severity score 3 (light orange) and score 4 (red) disappeared. Maximal effect on the 7d-RBD_SS reflected by a low severity score value of 1 per week (dark blue) was recorded by patient and spouse in week 9. Wash-out of AL was carried out in week 16. Note the long-lasting beneficial effect of AL on the RBD-severity score until week 22 and the marked rebound in RBD symptoms (reappearance of score value 4 (red)). These severe RBD scores were controlled by reintroducing the AL therapy—with a latency of 5 weeks. Following the first AL withdrawal, overall, during the subsequent observational period of 17 months under AL therapy and independent of the second washout period, only 3 short episodes with a marked RBD-severity score 4 (red) were reported
See this image and copyright information in PMC

References

    1. Postuma RB, Iranzo A, Hu M et al (2019) Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 142:744–759. 10.1093/brain/awz030 - PMC - PubMed
    1. Sixel-Döring F, Muntean M-L, Petersone D et al (2023) The Increasing prevalence of rem sleep behavior disorder with Parkinson’s disease progression: a polysomnography-supported study. Mov Disord Clin Pract 10:1769–1776. 10.1002/mdc3.13908 - PMC - PubMed
    1. Fanciulli A, Sixel-Döring F, Buhmann C et al (2025) Diagnosis and treatment of autonomic failure, pain and sleep disturbances in Parkinson’s disease: guideline “Parkinson’s disease” of the German Society of Neurology. J Neurol 272(1):90. 10.1007/s00415-024-12730-5 - PMC - PubMed
    1. Fields T, Schoser B, Oertel W, Strupp M (2021) Acetyl-DL-leucine improves restless legs syndrome: a case report. J Neurol 268(7):2595–2596. 10.1007/s00415-021-10625-3 - PubMed
    1. Oertel WH, Janzen A, Henrich MT et al (2024) Acetyl-DL-leucine in two individuals with REM sleep behavior disorder improves symptoms, reverses loss of striatal dopamine-transporter binding and stabilizes pathological metabolic brain pattern-case reports. Nat Commun 15:7619. 10.1038/s41467-024-51502-7 - PMC - PubMed

LinkOut - more resources