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Sleep Europe 2026 | Alpha-synuclein and amyloid copathology in iRBD: prevalence and clinical significance
Gerard Mayà Casalprim, MD, PhD, Hospital Clínic de Barcelona, Barcelona, Spain, discusses alpha-synuclein and amyloid biomarkers in patients with isolated REM sleep behavior disorder (iRBD), highlighting how amyloid positivity may increase the risk of dementia and progression towards a dementia with Lewy bodies phenotype. This interview took place at Sleep Europe 2026, which was held in Maastricht, Netherlands.
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Transcript
When we assess the CSF alpha-synuclein in patients with iRBD, 75% of them are already synuclein positive and in the negative patients, 21% of them are positive three years later. In all these patients, even the negative synuclein iRBD patients, in all of them, 22% are amyloid positive, which is the beginning of Alzheimer’s pathology. And we know that if they have biomarkers of Alzheimer’s disease, the risk of developing dementia and the dementia with Lewy bodies phenotype is higher...
When we assess the CSF alpha-synuclein in patients with iRBD, 75% of them are already synuclein positive and in the negative patients, 21% of them are positive three years later. In all these patients, even the negative synuclein iRBD patients, in all of them, 22% are amyloid positive, which is the beginning of Alzheimer’s pathology. And we know that if they have biomarkers of Alzheimer’s disease, the risk of developing dementia and the dementia with Lewy bodies phenotype is higher. So the phenoconversion tends towards a dementia clinical profile.
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