About this trial
REM sleep behavior disorder is a parasomnia that reflects the presence of alpha-synucleinopathy in the brain and is highly predictive of eventual phenoconversion to Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy over the course of years to decades. Neuroplastic adaptations in the brain during the prodromal stage of disease are thought to mask the expression of motor and non-motor signs and may substantially delay diagnosis during a potentially critical time window. This study will examine the state and progression (over 30 to 36 months) of neuroplastic changes in the excitability of the motor and prefrontal cortex (using transcranial magnetic stimulation), the structural and functional connectivity of the brain (using highfield, 7T, magnetic resonance imaging), and the relationship of these changes to the expression of motor and neuropsychological signs, in a cohort of individuals with REM sleep behavior disorder and matched controls.
Eligibility criteria
Qualifiers
Diagnosis of polysomnogram-confirmed isolated iRBD.
Able to ambulate independently without the use of an assistive device (e.g., cane) for 50 meters.
Age: 21-75 years.
Age: 21-75 years.
Disqualifiers
Dementia diagnosis and/or a University of California Brief Assessment of Capacity to Consent (UBACC) score and MacCAT-CR score indicating impaired capacity to consent.
History of musculoskeletal disorders that significant affect movement of lower or upper limbs as determined at the time of enrollment.
Other significant neurological disorders that may affect participation or performance in the study.
Anti-depressant associated RBD. Individuals will be excluded if their dream enactment emerged or clearly worsened after initiating an antidepressant medication.
Trial design
Treatments tested in this trial
- Natural progression over time