Objective: Aim of the study was to evaluate subtle alterations of turning in iRBD subjects in absence of parkinsonism using Mobile health technology (MHT).

Background: Idiopathic REM sleep Behavioral Disorder (iRBD) is a condition at increased risk of developing Parkinson’s disease (PD) and other alpha-synucleinopathies.

Method: The study included polysomnography-confirmed iRBD, drug-naïve PD patients and age-matched controls (HC). Each subject underwent a multidimensional assessment including a clinical neurological examination, as well as cognitive and non-motor symptoms assessment. Then a Timed Up and Go test (TUG) at normal and fast speed was performed using MHT (Rehagait®, Hasomed,Germany). Mean and peak angular velocities during the turns were compared using a multivariate model and correcting for age and sex.

Results: Of the 147 included participants, 23 had iRBD, 59 PD and 65 served as HC. None of the iRBD participants showed signs of parkinsonism (MDS-UPDRS-III iRBD 2±2, PD 16±10). Mean and peak angular velocities during the turns were reduced in PD compared to HC in normal and fast TUG (p=<0.001). iRBD participants showed reduced mean and peak angular velocity during normal TUG (respectively p=0.006 and p<0.001) but not during fast TUG, compared to HC.

Conclusion: In this cross-sectional study, MHT assessment identified subtle alterations of turning at normal speed in iRBD patients without any clinical signs of parkinsonism. The lack of difference during fast speed may indicate the presence of (unconscious) compensation mechanisms that are activated during more challenging conditions. Longitudinal studies are warranted to evaluate the value of angular velocity in tracking motor progression in prodromal PD and in defining the risk of conversion to PD in iRBD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/turning-alterations-detected-by-mobile-health-technology-in-idiopathic-rem-sleep-behavioral-disorders/