Clinical Biomarkers of Neurodegeneration in REM Sleep Behavior Disorder

Abstract

Address for correspondence Yun Kwok Wing, FRCPsych Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR Tel: +852-26367748 Fax: +852-26475321 E-mail: ykwing@cuhk.edu.hk Rapid eye movement sleep behavior disorder (RBD) is currently considered as a prodromal stage of α-synucleinopathies neurodegeneration. The update data suggested that over 80% patients with idiopathic RBD eventually developed neurodegenerative disease after a mean of 14 years interval from the onset of RBD. A series of potential biomarkers have been identified to predict the development of neurodegeneration in idiopathic RBD, including olfactory loss, color vision deficit, depression, mild cognitive impairment, excessive daytime sleepiness, dopamine dysfunction, and tonic electromyographic activity. Early recognition of the predictive markers of neurodegeneration in idiopathic RBD is essential for development of intervention or prevention strategies at the presymptomatic stage. Nonetheless, the current literature is lacking biomarkers that might reflect the α-synuclein neuropathology at the earliest stages. Future studies with large samples and systematic follow-up are needed to confirm more potential markers of neurodegeneration at its early stages. J Sleep Med 2015;12(2):27-33