REM sleep disorder is a precursor to Parkinson’s disease

A team of researchers from the Barcelona Clinic-IDIBAPS showed that isolated REM sleep behavior disordercharacterized by nightmares and abnormal behavior, is the initial stage neurodegenerative diseases such as Parkinson’s disease, dementia with Lewy bodies (DLB) and multiple system atrophy (MSA)), among others.

Research published in Lancet Neurology, It was led by Dr. Alex Iranzo and Dr. Gerard Maia, together with the multidisciplinary team of the Barcelona Clinic-IDIBAPS and the IDIBAPS Neurological Tissue Bank. This work is the first to detail the association between this isolated sleep behavior disorder. with rapid eye movement (iRBD) and α-synuclein accumulation.

iRBD: a path to early detection

iRBD is characterized by abnormal behavior during REM sleep, such as screaming or twitching, due to a lack of muscle relaxation. The same group of researchers had previously implicated the disorder as a precursor to neurodegenerative diseases in a study begun in 2006, but until now there had been no conclusive evidence.

According to the Hospital Clínic, the evidence was obtained from detailed postmortem study of the brain and spinal cord of 20 patients diagnosed with iRBD.. The results show a “clear” link between iRBD and the accumulation of alpha-synuclein in several brain regions, so the researchers view it as a “very early sign of neurodegeneration.”

Clinical implications and future treatments

The results highlight the importance of iRBD as a biomarker for the early detection of α-synucleinopathies (diseases that share abnormal deposition of this protein). Likewise, they open up new opportunities for developing treatments that target not only alpha-synuclein but also other pathological proteins. The study suggests that clinical trials that combine different pathological proteins may be a “promising” strategy for preventing or delaying the onset of Parkinson’s disease and dementia in people with iRBD.