Cognitive and Movement Disorders in REM Sleep Behavior
Summary
Rapid eye movement sleep behaviour disorder (RBD) is characterised by the loss of physiological muscle atonia and the emergence of dream enactment and vocalisations during REM sleep. Beyond its defining motor phenomena, RBD is widely recognised as a prodromal manifestation of α-synucleinopathies, notably Parkinson’s disease and dementia with Lewy bodies. Individuals frequently exhibit mild motor impairments that reflect early nigrostriatal dysfunction alongside cognitive deficits spanning attention, executive control, memory and visuospatial processing. Neuroimaging investigations have uncovered disruptions in functional connectivity across brainstem, basal ganglia and cortical networks, as well as progressive cortical thinning in temporal, frontal and parietal regions. Collectively, these findings establish RBD as a critical window into incipient neurodegeneration, offering avenues for biomarker development, participant stratification and early therapeutic intervention on a global scale.
Research from Nature Portfolio
The relationship between motor and non-motor symptoms and dopaminergic integrity has been elucidated through dopamine transporter single-photon emission computed tomography. In patients with idiopathic RBD, reduced striatal binding correlates with enhanced tonic and phasic muscle activity during REM sleep and higher motor severity scores, reflecting parallel advancement of pathology in substantia nigra and susceptible brainstem nuclei. This work underscores the prognostic value of objective imaging biomarkers to identify individuals at highest risk of phenoconversion and to inform neuroprotective trial design.
Cognitive and Movement Disorders in REM Sleep Behavior publication trend
The graph below shows the total number of articles in cognitive and movement disorders in rem sleep behavior across all publications each year (not limited to Nature Index journals).
Technical terms
Rapid eye movement sleep behaviour disorder (RBD): A parasomnia marked by loss of muscle atonia and dream enactment movements during REM sleep, often preceding synucleinopathies.
Dopamine transporter single-photon emission computed tomography (DAT-SPECT): An imaging modality that quantifies presynaptic dopamine transporter availability, indicative of nigrostriatal integrity.
Functional connectivity: The statistical association between spatially distinct brain regions, often measured by correlations in resting-state fMRI signals.
Cortical thickness: A structural MRI measure of the distance between the white and grey matter boundaries, used to assess regional atrophy.
Executive functions: Higher-order cognitive processes including planning, inhibition, working memory and cognitive flexibility.
Phenoconversion: The transition from a prodromal clinical state to a defined neurodegenerative disease, such as Parkinson’s disease or dementia with Lewy bodies.
References
- Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder. npj Digital Medicine (2024).
- Longitudinal evolution of cortical thickness signature reflecting Lewy body dementia in isolated REM sleep behavior disorder: a prospective cohort study. Translational Neurodegeneration (2023).
- Understanding REM Sleep Behavior Disorder through Functional MRI: A Systematic Review. Movement Disorders (2024).
- Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder. Scientific Reports (2019).
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