Chromatic Pupillometry in Isolated Rapid Eye Movement Sleep Behavior Disorder

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Abstract

Background

Melanopsin retinal ganglion cell (mRGC)‐mediated pupillary light reflex (PLR) abnormalities have been documented in several neurodegenerative disorders including Parkinson's disease. Overall, isolated rapid eye movement (REM) sleep behavior disorder (iRBD) represents the strongest prodromal risk factor for impending α‐synucleinopathies.

Objectives

To quantitatively compare PLR and mRGC‐mediated contribution to PLR in 16 iRBD patients and 16 healthy controls.

Methods

iRBD and controls underwent extensive neuro‐ophthalmological evaluation and chromatic pupillometry. In iRBD, PLR metrics were correlated with clinical variables and with additional biomarkers including REM atonia index (RAI), DaTscan, and presence of phosphorylated‐α‐synuclein (p‐α‐syn) deposition in skin biopsy.

Results

We documented higher baseline pupil diameter and decreased rod‐transient PLR amplitude in iRBD patients compared to controls. PLR rod‐contribution correlated with RAI. Moreover, only iRBD patients with evidence of p‐α‐syn deposition at skin biopsy showed reduced PLR amplitude compared to controls.

Conclusion

The observed PLR abnormalities in iRBD might be considered as potential biomarkers for the risk stratification of phenoconversion of the disease. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

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Most cited references 20

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International Classification of Sleep Disorders

American Academy of Sleep Medicine (2014)

"The International Classification of Sleep Disorders - Third Edition (ICSD-3) is the authoritative clinical text for the diagnosis of sleep disorders. This is an essential reference for all clinicians with sleep disorders patients. Updated in 2014, the third revision to the ICSD features significant content changes, including new nomenclature, classifications and diagnoses. The book also features accurate diagnostic codes for the corresponding ICD-9 and ICD-10 diagnoses at the beginning of each diagnosis section of the ICSD-3. Disorders are grouped into six major categories: Insomnia ; Sleep Related Breathing Disorders ; Central Disorders of Hypersomnolence ; Circadian Rhythm Sleep-Wake Disorders ; Parasomnias ; Sleep Related Movement Disorders." --

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Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study

Ronald Postuma, Alex Iranzo, Michele Hu … (2019)

See Morris and Weil (doi:10.1093/brain/awz014) for a scientific commentary on this article. In a prospective multicentre study involving 1280 patients with idiopathic RBD, Postuma et al. show that approximately 6% of patients each year (>73.5% over 12 years) convert to full neurodegenerative disease. They test the predictive power of 21 prodromal markers of neurodegeneration, providing a template for planning neuroprotective trials.

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Idiopathic REM sleep behaviour disorder and neurodegeneration — an update

Aleksandar Videnovic, Ambra Stefani, Birgit Högl (2017)

So-called idiopathic rapid eye movement (REM) sleep behaviour disorder (RBD), formerly seen as a rare parasomnia, is now recognized as the prodromal stage of an α-synucleinopathy. Given the very high risk that patients with idiopathic RBD have of developing α-synucleinopathies, such as Parkinson disease (PD), PD dementia, dementia with Lewy bodies or multiple system atrophy, and the outstandingly high specificity and very long interval between the onset of idiopathic RBD and the clinical manifestations of α-synucleinopathies, the prodromal phase of this disorder represents a unique opportunity for potentially disease-modifying intervention. This Review provides an update on classic and novel biomarkers of α-synuclein-related neurodegeneration in patients with idiopathic RBD, focusing on advances in imaging and neurophysiological, cognitive, autonomic, tissue-specific and other biomarkers. We discuss the strengths, potential weaknesses and suitability of these biomarkers for identifying RBD and neurodegeneration, with an emphasis on predicting progression to overt α-synucleinopathy. The role of video polysomnography in providing quantifiable and potentially treatment-responsive biomarkers of neurodegeneration is highlighted. In light of all these advances, and the now understood role of idiopathic RBD as an early manifestation of α-synuclein disease, we call for idiopathic RBD to be reconceptualized as isolated RBD.

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Author and article information

Contributors

Chiara La Morgia:

ORCID: https://orcid.org/0000-0002-4639-8929

chiara.lamorgia@isnb.it

Journal

Journal ID (nlm-ta): Mov Disord

Journal ID (iso-abbrev): Mov Disord

Journal ID (doi): 10.1002/(ISSN)1531-8257

Journal ID (publisher-id): MDS

Title: Movement Disorders

Publisher: John Wiley & Sons, Inc. (Hoboken, USA )

ISSN (Print): 0885-3185

ISSN (Electronic): 1531-8257

Publication date (Electronic): 07 October 2021

Publication date (Print): January 2022

Volume: 37

Issue: 1 ( doiID: 10.1002/mds.v37.1 )

Pages: 205-210

Affiliations

[ ¹ ] IRCCS Istituto delle Scienze Neurologiche di Bologna UOC Clinica Neurologica Bologna Italy

[ ² ] Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy

[ ³ ] Department of Basic Medicine, Neuroscience, and Sense Organs University of Bari "Aldo Moro" Bari Italy

[ ⁴ ] Center for Neurodegenerative Diseases and the Aging Brain University of Bari "Aldo Moro"‐ A.O. Pia Fondazione Cardinale G. Panico Tricase Italy

[ ⁵ ] Department of Ophthalmology and Visual Sciences University of Illinois at Chicago Chicago Illinois USA

[ ⁶ ] Dipartimento di Neuroscienze, Biomedicina e Movimento Università di Verona Verona Italy

[ ⁷ ] Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy

Author notes

[*] [* ] * Correspondence to: Dr. Chiara La Morgia, IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Via Altura 3, 40139, Bologna, Italia. E‐mail: chiara.lamorgia@ 123456isnb.it

Author information

Chiara La Morgia https://orcid.org/0000-0002-4639-8929

Martina Romagnoli https://orcid.org/0000-0003-1995-558X

Marco Filardi https://orcid.org/0000-0001-9702-8314

Vincenzo Donadio https://orcid.org/0000-0002-1290-7318

Elena Antelmi https://orcid.org/0000-0003-1739-6139

Article

Publisher ID: MDS28809

DOI: 10.1002/mds.28809

PMC ID: 9293298

PubMed ID: 34617633

SO-VID: 46382b11-37ec-4d08-99dc-5526c5fcf32e

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

History

Date revision received : 01 August 2021

Date received : 15 May 2021

Date accepted : 10 September 2021

Page count

Figures: 1, Tables: 1, Pages: 35, Words: 3774

Custom metadata

source-schema-version-number 2.0

cover-date January 2022

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:18.07.2022

ScienceOpen disciplines: Medicine

Keywords: pupillometry,rem sleep behavior disorder,synucleinopathy,neurodegeneration,melanopsin

Data availability:

ScienceOpen disciplines: Medicine

Keywords: pupillometry, rem sleep behavior disorder, synucleinopathy, neurodegeneration, melanopsin

Chromatic Pupillometry in Isolated Rapid Eye Movement Sleep Behavior Disorder

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Abstract

Background

Objectives

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Results

Conclusion

Related collections

Neuronal Signaling

Most cited references 20

International Classification of Sleep Disorders

Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study

Idiopathic REM sleep behaviour disorder and neurodegeneration — an update

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Contributors

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