Objective: To detect non-motor symptoms in individuals at-risk for Parkinson’s disease (PD) due to idiopathic REM sleep behavior disorder (RBD) and determine the rate of conversion to alpha-synucleinopathy.

Background: RBD is a condition where dreams are physically acted out due to lack of muscle tone inhibition during this sleep stage. RBD is characterized as idiopathic or symptomatic and has a general prevalence of 0.74-4.5%. RBD is associated with an estimated risk of synucleinopathy of up to 90.9% at 14 years. Studies show many non-motor Parkinson’s disease symptoms in RBD patients.

“Parkinson’s disease risk syndrome” includes individuals who are at an increased risk of developing PD in the future. It is important to detect non-motor symptoms early, as these can significantly decrease a patient’s quality of life. Unfortunately, there is still no treatment available for managing these symptoms or providing neuroprotective therapy. This study included subjects at risk for PD and other synucleinopathies in order to better define the disease’s longitudinal behavior.

Method: We conducted an observational study with repeated cross-sectional evaluations at baseline and a second evaluation at 2 years later. The eligible population included patients of any gender and age with idiopathic REM sleep behavior disorder diagnosed by polysomnography who attended a reference center during 2019. Participants completed several tests including Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Nonmotor Symptoms Scale (NMSS), EQ-5D-5L, University of Pennsylvania Smell Identification Test (UPSIT), and Montreal Cognitive Assessment (MoCA) twice. Phenotypic conversion to any synucleinopathy was recorded.

Results: 11 patients participated in the study. Dysautonomic symptoms (urinary function) worsened, but motor symptoms did not (Figure 1).

No cases of phenotypic conversion to synucleinopathy were observed, nonetheless, a significant worsening in the quality was demonstrated by comparing both evaluations. Hyposmia was the factor most subjectively associated with this result.

Conclusion: Non-motor symptoms, especially of the dysautonomic type, are quite common in the Hispanic mexican population diagnosed with idiopathic REM sleep behavior disorder. These symptoms have a significant impact on their quality of life. Further research with larger sample sizes and longer follow-up periods are required.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-severity-of-non-motor-symptoms-in-hispanic-at-risk-population-with-rem-sleep-behavior-disorder/