Abstract Details

Title Biological Characteristics of Individuals with RBD: A Multicenter Prospective Longitudinal Cohort

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-001

Objective Examine baseline clinical and biological characteristics of participants with polysomnography-confirmed REM Sleep Behavior Disorder (RBD).

Background RBD is an early manifestation of underlying synucleinopathy with progression to a clinical synucleinopathy in over 70%. Prevalence of synuclein aggregation in cerebrospinal fluid (CSF) and dopaminergic deficit on DaT scans (D+) in individuals with RBD is not well established. We compare baseline biological and clinical characteristics in RBD between groups distinguished by presence (S+) or absence (S-) of synuclein aggregates.

Design/Methods 290 RBD participants were enrolled in a multicenter prospective longitudinal cohort study, the Parkinson Progression Markers Initiative. Aggregated alpha-synuclein was assessed in CSF using seed amplification assay (SAA) and dopaminergic dysfunction was assessed using SPECT scan. Baseline data were summarized and S+ and S- groups were compared. Three participants had MSA-like SAA and were excluded from the comparison.

Results At baseline, mean age overall was 67.8 (6.3) years and 79% were male. 72% were SAA+ and 48% were D+ (<75% of age/sex-expected lowest putamen SBR). S+ participants were more frequently hyposmic (UPSIT<15%, 89% vs 20%) and D+ (54% vs 32%). Self-reported depression and anxiety were more prominent in the S- group (MDS-UPDRS I.3, Geriatric Depression Scale, MDS-UPDRS 1.4, State-Trait Anxiety Inventory). Motor symptoms (MDS-UPDRS III) and cognitive assessments (MoCA) were not significantly different between groups.

Conclusions

We present biological and clinical data of a large RBD cohort. Nearly three-quarters were S+ and approximately half were D+. This is consistent with the hypothesis that alpha-synuclein aggregation precedes dopaminergic deficit detectable on DaT scan.

The S+ cohort’s biological profile identified hyposmia and presence of dopaminergic deficit, while the S- cohort’s profile identified more self-reported mood disturbances. Longitudinal biological and clinical monitoring in people with RBD will define predictors and timelines of progression and provide opportunities for future interventions.

Authors/Disclosures
Jeanne Feuerstein, MD (University of Colorado School of Medicine) PRESENTER	Dr. Feuerstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceutical. The institution of Dr. Feuerstein has received research support from Mowry Fund Grant. The institution of Dr. Feuerstein has received research support from Davis Phinney. Dr. Feuerstein has received research support from MJFF - Write Now Initiative. Dr. Feuerstein has received personal compensation in the range of $500-$4,999 for serving as a Parkinson's Expert for Legal Case with Keating Wagner Palidori. Dr. Feuerstein has received personal compensation in the range of $100,000-$499,999 for serving as a Attending Neurologist with VAMC. Dr. Feuerstein has received personal compensation in the range of $100,000-$499,999 for serving as a Assistant Professor of Neurology with University of Colorado.
Ethan G. Brown, MD (University of California, San Francisco)	Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Rune Labs, Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Guidepoint Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brown has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Knowledge Plus. Dr. Brown has stock in 153 Therapeutics. The institution of Dr. Brown has received research support from Michael J. Fox Foundation. The institution of Dr. Brown has received research support from NIH.
Lana Chahine, MD, FAAN	Dr. Chahine has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gray Matters Technology. The institution of Dr. Chahine has received research support from UPMC. The institution of Dr. Chahine has received research support from MJFF. The institution of Dr. Chahine has received research support from Denali/Biogen. Dr. Chahine has received publishing royalties from a publication relating to health care.
Caroline Gochanour (University of Iowa CTSDMC)	An immediate family member of Caroline Gochanour has stock in Pfizer.
David-Erick Lafontant	Mr. Lafontant has nothing to disclose.
Micah Marshall	Mr. Marshall has nothing to disclose.
Tanya Simuni, MD, FAAN (Northwestern University Feinberg School of Medicien)	Dr. Simuni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for cadia, AcureX, Adamas, AskBio, Amneal, Blue Rock Therapeutics, Caraway Therapeutics, Critical Path for Parkinson's Consortium (CPP), Denali, Michael J Fox Foundation, Neuroderm, Sanofi, Sinopia, Roche, Takeda and Vanqua Bio. Dr. Simuni has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for of Koneksa, Neuroderm, Sanofi, UCB, AcureX, Adamas, AskBio, Biohaven, Denali, GAIN, Neuron23 and Roche. Dr. Simuni has received research support from Amneal, Biogen, Neuroderm, Prevail, Roche, and UCB and an investigator for NINDS, MJFF, Parkinson's Foundation.
Daniel Weintraub	Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Clintrex. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scion. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Modality.ai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CuraSen. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Takeda. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorder Society. The institution of Daniel Weintraub has received research support from NIH. The institution of Daniel Weintraub has received research support from Fox Foundation. The institution of Daniel Weintraub has received research support from IPMDS. Daniel Weintraub has received intellectual property interests from a discovery or technology relating to health care.
Amy W. Amara, MD PhD (University of Colorado Anschutz Medical Center)	The institution of Dr. Amara has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Photopharmics, Inc. The institution of Dr. Amara has received research support from Michael J Fox Foundation for Parkinson's Research . The institution of Dr. Amara has received research support from Biogen Idec. The institution of Dr. Amara has received research support from NIH.

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