Objective: Isolated REM sleep behavior disorder (RBD) is a strong prodromal marker of Parkinson’s disease (PD) and related alpha-synucleinopathies. Early identification is crucial for timely intervention and potential disease-modifying treatments. This systematic review evaluates novel non-polysomnography tools for home-based RBD detection, assessing their feasibility and clinical applicability.

Background: While video-polysomnography (vPSG) is the gold standard for RBD diagnosis, its high cost and resource-intensive nature limit its widespread use. Novel wearable and contactless technologies may offer promising alternatives for large-scale screening and early risk stratification of PD.

Method: We performed a systematic search in PubMed, Web of Science, and Cochrane Library. Study quality, diagnostic accuracy, sensitivity and specificity were evaluated.

Results: A total of 17 studies were identified and categorized into actigraphy-based devices (n=9), novel tools (n=5), and emerging modalities (n=3). Actigraphy devices, particularly those integrating machine learning and RBD-specific questionnaires, showed improved diagnostic accuracy. Novel tools, including portable biopotential systems and temporary tattoo EEG, demonstrated potential for home-based REM sleep without atonia detection. Contactless motion-tracking technologies, such as 3D time-of-flight cameras, exhibited high sensitivity for dream-enacting behavior.

Conclusion: Emerging non-PSG technologies enhance accessibility to iRBD screening and could aid in early PD identification. Most tools serve as screening instruments, with specificity potentially improved by additional clinical data. Future research should focus on validation, cost-effectiveness, and multicenter studies to ensure clinical reliability.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/novel-technologies-for-rem-sleep-behavior-disorder-detection-to-identify-prodromal-parkinsons-disease-at-home/