A REM sleep disorder is a precursor to neurodegenerative diseases such as Parkinson’s, as confirmed by a study by the Hospital Clínic Barcelona-Idibaps that opens the door to developing strategies to prevent or delay the onset of dementia in affected people.
Isolated REM sleep behavior disorder with rapid eye movement (iRBD) is a parasomia (abnormal behavior that occurs during sleep) characterized by aggressive behaviors such as screaming or punching, associated with REM sleep without muscle relaxation.
Previous research has linked this disorder as a precursor to neurodegenerative diseases, but until now there was a lack of scientific evidence that could confirm its link with major disorders such as Parkinson’s, dementia with Lewy bodies or multiple system atrophy.
Alpha-simuclein accumulation in the brain causes sleep disorders and is a marker of neurodegeneration
As a continuation of a line of work begun in 2006, Idibaps researchers have examined the post-mortem brains and spinal cords of 20 patients diagnosed with iRBD and have found a clear link between this disorder and the accumulation of alpha-synuclein in several areas. of the brain.
The study, published in The Lancet Neurologyshows that early identification of iRBD could be a key biomarker for the progression of alpha-synucleopathies (neurodegenerative diseases characterized by the abnormal accumulation of alpha-synuclein protein in neurons, nerve fibers or glial cells).
Álex Iranzo, head of the Clínic’s sleep disorders unit, leads the study, together with neurologist Gerard Mayà and Raquel Sánchez-Valle, head of the Alzheimer’s disease and other cognitive disorders group at Idibaps. It is the study with the most cases where the relationship between iRBD and diseases such as Parkinson’s is confirmed in a detailed and definitive manner.
Gerard Mayà and Álex Iranzo
According to the research group, one of the most revealing findings was the identification of alpha-synuclein deposits in brain regions critical for the regulation of REM sleep. In patients who had not developed dementia, deposits of this protein were found in the brain stem and limbic system. On the contrary, in those who had developed Parkinson’s or dementia with Lewy bodies, the deposits were much more extensive and were not only present in neurons, but also in glial cells (in the central nervous system, they interact with neurons). .
On the other hand, 14 of the 20 patients studied had a high prevalence of neuropathological changes typical of Alzheimer’s. “This may suggest that iRBD could also be linked to an increased risk of developing Alzheimer’s, although its implication is still unclear,” says Gerard Mayà.
Researchers have studied in detail the brains and spinal cords of 20 corpses
In conclusion, the study proves that the accumulation of alpha-synuclein in brain structures involved in REM sleep can serve as an early biomarker to identify the risk of suffering from neurodegenerative diseases such as Parkinson’s and dementia with Lewy bodies.
Furthermore, in the opinion of the researchers, “new opportunities are opening up to design therapies aimed not only at alpha-synuclein but also at other pathological proteins such as beta-amyloid and tau, which could be influencing the progression towards parkinsonism.” and dementia.”
The work has received support from a BBVA Foundation-Hospital Clínic Barcelona Joan Rodés-Josep Baselga Advanced Research Contract.
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