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Rapid eye movement sleep behavior disorder and the link to alpha-synucleinopathies.

TitleRapid eye movement sleep behavior disorder and the link to alpha-synucleinopathies.
Publication TypeJournal Article
Year of Publication2018
AuthorsBarone DA, Henchcliffe C
JournalClin Neurophysiol
Volume129
Issue8
Pagination1551-1564
Date Published2018 08
ISSN1872-8952
Keywordsalpha-Synuclein, Cross-Sectional Studies, Electroencephalography, Humans, Lewy Body Disease, Longitudinal Studies, Multiple System Atrophy, Parkinson Disease, REM Sleep Behavior Disorder
Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) involves REM sleep without atonia in conjunction with a recurrent nocturnal dream enactment behavior, with vocalizations such as shouting and screaming, and motor behaviors such as punching and kicking. Secondary RBD is well described in association with neurological disorders including Parkinson's disease (PD), multiple system atrophy (MSA), and other conditions involving brainstem structures such as tumors. However, RBD alone is now considered to be a potential harbinger of later development of neurodegenerative disorders, in particular PD, MSA, dementia with Lewy bodies (DLB), and pure autonomic failure. These conditions are linked by their underpinning pathology of alpha-synuclein protein aggregation. In RBD, it is therefore important to recognize the potential risk for later development of an alpha-synucleinopathy, and to investigate for other potential causes such as medications. Other signs and symptoms have been described in RBD, such as orthostatic hypotension, or depression. While it is important to recognize these features to improve patient management, they may ultimately provide clinical clues that will lead to risk stratification for phenoconversion. A critical need is to improve our ability to counsel patients, particularly with regard to prognosis. The ability to identify who, of those with RBD, is at high risk for later neurodegenerative disorders will be paramount, and would in addition advance our understanding of the prodromal stages of the alpha-synucleinopathies. Moreover, recognition of at-risk individuals for neurodegenerative disorders may ultimately provide a platform for the testing of possible neuroprotective agents for these neurodegenerative disorders.

DOI10.1016/j.clinph.2018.05.003
Alternate JournalClin Neurophysiol
PubMed ID29883833
PubMed Central IDPMC6495539
Grant ListUL1 TR002384 / TR / NCATS NIH HHS / United States

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