Rapid Eye Movement Sleep Behavior Disorder and Neurodegenerative Diseases: An Update

Zhang Feng, Niu Long, Liu Xinyao, Liu Yufei, Li Song, Yu Huan, Le Weidong

Table 1 Summarized prevalence, gender difference and underlying mechanisms of RBD in neurodegenerative diseases.

Disease Prevalence Gender difference Possible mechanisms of pathogenesis of RBD PD 42.3%[50] Male>female [51] α-syn pathology affects the circuit that regulates REM sleep, associated with GBA [39], SCARB2 [40], MAPT [40], USP25[40], PINK1 [41], LRRK2 [2] mutations MSA 88%[33] Female>male [59] α-syn pathology affects the circuit that regulates REM sleep, depletion of cholinergic neurons in the PPN/LDTN complex, periaqueductal grey matter, and LC [33] PSP 13%[13] - Loss of cholinergic neurons in the pedunculopontine tegmentum [13] CBD Case reports[38, 68] 2 female patients [38, 68] Degenerative process in cortical and subcortical structures and in the nuclei of the brain stem and pedunculopontine pathways [38]. AD 4.8-26.7%[12, 71] Male>female [12] An imbalance of neurotransmitter acetylcholine [12], neuronal loss in LC [12] DLB 46.7-83%[81-83] Male>female [82] α-syn pathology affects the circuit that regulates REM sleep [4] FTD Rare (only case report)[90] 1 male patient [90] Associated with C9ORF72 repeat expansion [89] VaD 25.6%-72.6%[81, 93] - Hypoperfusion or hemodynamic abnormalities affect the brain areas that regulate REM sleep [4] HD 12% or lower[14, 96] Female>male [14] Associated with mutant huntingtin [14] ALS 4.9%[15] 2 male patients [15] Neurodegeneration of nuclei in REM-associated pathways in the brainstem and the dysfunction of dopaminergic system in substantia nigra striatum may be the main pathophysiological culprit in the development of RBD [15], associated with C9ORF72 repeat expansion [91, 100] CJD 7.1%[101] 2 male patients [101] Associated with corticothalamic degeneration [102]