Integrating EEG to stratify severity progression and neurodegenerative risk in REM sleep behaviour disorder RBD

RBD manifests through failure of skeletal muscle atonia during REM sleep, culminating in unchecked dream-related motor activity, typically of an aggressive and physical nature. These motor symptoms clearly implicate degeneration of brainstem circuits in RBD. However, more than 80% of males over 50 presenting with RBD subsequently develop broader neurodegenerative disorders, most notably Parkinson's disease (PD). In turn, PD patients with concomitant RBD are more prone to affective and cognitive dysfunction. RBD therefore constitutes a uniquely powerful model of prodromal PD, well-placed to illuminate mechanisms of risk, progression and non-motoric symptoms.