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REM sleep behaviour disorder: prodromal and mechanistic insights for Parkinson's disease
  1. Anand Tekriwal1,
  2. Drew S Kern2,
  3. Jean Tsai2,
  4. Nuri F Ince3,
  5. Jianping Wu4,
  6. John A Thompson1,
  7. Aviva Abosch1
  1. 1Department of Neurosurgery, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
  2. 2Department of Neurology, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
  3. 3Biomedical Engineering, University of Houston, Houston, Texas, USA
  4. 4Neuromodulation Global Research, Medtronic, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Aviva Abosch, Department of Neurosurgery, University of Colorado-Anschutz Medical Center, Denver, CO 80113, USA; aviva.abosch{at}


Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterised by complex motor enactment of dreams and is a potential prodromal marker of Parkinson's disease (PD). Of note, patients with PD observed during RBD episodes exhibit improved motor function, relative to baseline states during wake periods. Here, we review recent epidemiological and mechanistic findings supporting the prodromal value of RBD for PD, incorporating clinical and electrophysiological studies. Explanations for the improved motor function during RBD episodes are evaluated in light of recent publications. In addition, we present preliminary findings describing changes in the activity of the basal ganglia across the sleep–wake cycle that contribute to our understanding of RBD.

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  • Acknowledgements The authors thank Drs Urrestarazu and Artieda for allowing us to use of figures from their 2009 publication ‘β Activity in the Subthalamic Nucleus During Sleep in Patients with Parkinson's Disease’.

  • Contributors AT conceived the manuscript with significant input from co-authors. NFI and JAT provided assistance with processing data depicted in figures 1,4 and 5 DSK and JT evaluated the accuracy and value of statements concerning RBD and PD, and AA provided overall edits.

  • Funding This work was supported by National Science Foundation (CBET-1343548) and Medtronic.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval University of Minnesota Institutional Review Board.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement Preliminary data presented is being prepared for a manuscript.

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