ArticleEuropean journal of neurology2025
The Many Faces of REM Sleep Behavior Disorder. Providing Evidence for a New Lexicon.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Data-driven trajectories of atrophy explain clinical heterogeneity across Lewy body diseases.medRxiv : the preprint server for health sciences · 2026Article
- Neuroimaging and Pathology Biomarkers in Parkinson's Disease and Parkinsonism.Brain sciences · 2026Article
- REM Sleep Behavior Disorder as a Prodromal Synucleinopathy: Updates on Clinical and Laboratory Biomarkers, and Implications for Neuroprotective Trials.Current neurology and neuroscience reports · 2025Review
- Sleep and Stroke-An Overlooked Bidirectional Influence: Why Should Sleep and Vascular Neurologists Work Closer?Journal of clinical medicine · 2025Article
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Authors and funding
19 authors.
Funding
Abstract
backgroundPeople with idiopathic/isolated REM sleep behavior disorder (iRBD) are highly heterogeneous, showing mild motor, cognitive, and dysautonomia symptoms. The aim of this study is to unveil the clinical heterogeneity of iRBD with a specific reference to overlapping features with prodromal Parkinson's disease (pPD) and prodromal dementia with Lewy bodies (pDLB) labels.
methodsPeople with a polysomnography-confirmed diagnosis of iRBD were enrolled and followed over time. At baseline, pPD and pDLB criteria were assessed.
resultsAmong the 285 iRBD people (68.2 ± 7.6 years, 81% males), due to additional signs or symptoms, 49.8% fulfilled pPD criteria only, 5.6% pDLB criteria only, and 14.4% subjects fulfilled both pPD and pDLB criteria. Conversely, about one third of iRBD people (30.2%) did not meet either pPD or pDLB criteria. At follow-up (40.6 ± 43.6 months), 28.8% subjects phenoconverted, developing PD (56.1%), DLB (39%), or multiple system atrophy (4.9%). Subjects with iRBD fulfilling either pPD or pDLB criteria, or both, have an increased risk of phenoconversion (adjusted hazard ratio, aHR 2.34, 95% confidence interval, CI 1.24-4.41). On the opposite, subjects not fulfilling prodromal criteria have a significantly reduced short-term phenoconversion likelihood (aHR 0.43, 95% CI 0.23-0.81). Notably, pPD and pDLB criteria did not predict PD and DLB diagnoses, respectively.
conclusionsPeople with iRBD are highly heterogeneous, and the presence of other concomitant signs and symptoms is frequent, leading to faster phenoconversion. Thus, the terms idiopathic and isolated may be poorly appropriate and possibly even confounding. These results pave the way to a more appropriate new lexicon for people with RBD.
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