REM sleep behavior disorder (RBD) and neurodegeneration

First described by Schenck and collaborators, criteria for RBD are now defined by the ASDA and include complex behaviors during REM sleep with a loss of skeletal muscle atonia. Mild up to harmful body movements are associated with dream mentation and nightmares and disrupt sleep continuity. Polysomnographic evaluation is needed to establish a final diagnosis. RBD most likely reflects dysfunction in the brainstem circuitry and the dorsolateral pontine tegmentum, where REM sleep without atonia can be induced in animal experiments. Recent studies with cohorts of RBD patients point towards the hypothesis that RBD ma…