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EAN 2025 | Monitoring patients with idiopathic REM sleep behavior disorder for neurodegenerative diseases
Gerard Mayà Casalprim, MD, PhD, Hospital Clinic of Barcelona, Barcelona, Spain, discusses the monitoring of patients with idiopathic REM sleep behavior disorder (iRBD), who are at a high risk of developing neurodegenerative diseases. Dr Mayà Casalprim highlights that the currently available treatments only treat the symptoms, emphasizing the importance of monitoring these patients. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.
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Transcript
Patients that have REM sleep behavior disorder without an evident secondary cause such as Parkinson’s disease, narcolepsy, etc, they have a high risk of developing an overt alpha-synucleinopathy in the next years, more than 90% of those patients progress to Parkinson’s disease, 45%, more or less, dementia with Lewy bodies, 45%, and also around 5% multisystem atrophy after 15 years, with a risk each year surrounding 6-7%...
Patients that have REM sleep behavior disorder without an evident secondary cause such as Parkinson’s disease, narcolepsy, etc, they have a high risk of developing an overt alpha-synucleinopathy in the next years, more than 90% of those patients progress to Parkinson’s disease, 45%, more or less, dementia with Lewy bodies, 45%, and also around 5% multisystem atrophy after 15 years, with a risk each year surrounding 6-7%. Nowadays, still we don’t have a neuroprotective treatment for these patients. We only can offer them symptomatic treatment with clonazepam or melatonin as first line, but still we visit them, we follow up on them every 3 to 12 months, and if they present any new symptom that we can offer symptomatic treatment, such as levodopa for Parkinsonism or rivastigmine for cognitive problems. So we can start from the beginning of these symptoms when they are clinically relevant, the best symptomatic treatment that we can offer nowadays. And on the other side, but this is more for research purposes, we offer to all of these iRBD patients the possibility to look for alpha-synuclein in lumbar puncture, that scan, MRI, neuropsychological examination, and also olfactory test. And we do this even in a repetitive way in different years to understand better how this parasomnia progresses later to this neurodegenerative disorder.
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