Objective: To investigate the evolution of REM sleep behavior disorder (RBD) in a cohort of at baseline de novo Parkinson’s disease (PD) patients at follow-up after 2 years.

Background: In a de novo cohort of PD patients (DeNoPa cohort) we previously described RBD as well as REM sleep behavioral events (RBE) not fulfilling diagnostic criteria for RBD as a marker for neurodegeneration (1).

Methods: 113 PD patients with video-supported polysomnography (vPSG) data at baseline were re-investigated after 2 years. We assessed all motor activity during REM sleep, sleep architecture, clinical features and neuropsychological testing.

Results: Within two years the overall occurrence of behaviors during REM sleep in PD patients increased from 50% to 63%. RBD increased from 25% to 49%. Eleven of 26 (42%) initially RBE positive PD patients and 10/56 (18%) patients with normal REM sleep at baseline converted to RBD after 2 years. We failed to identify a specific PD phenotype associated with RBD/RBE at this early stage.

Conclusions: We propose RBE as prodromal RBD. Motor events in REM sleep may follow a continuous evolution in Parkinson syndromes possibly similar to the spreading of Lewy body pathology. RBD is a robust and stable marker for early PD. Reference: (1) Sixel-Döring F, Trautmann E, Mollenhauer B, Trenkwalder C. Rapid eye movements sleep behavioral events: a new marker for neurodegeneration in early Parkinson’s disease? SLEEP 2014; 37:431-8.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-evolution-of-rem-sleep-behavior-disorder-in-parkinsons-disease-the-denopa-cohort-at-2-year-follow-up/