Objective: To determine whether retinal structures are altered with the onset of rapid eye movement (REM) in Parkinson’s disease (PD).

Background: Rapid eye movement (REM) sleep behavior disorders (RBD) are characterized by a loss of typical muscle atonia during REM sleep and prominent motor activity associated with dreaming. RBD is a well-established prodromal hallmark of synucleinopathies and occurs secondary to neurodegenerative diseases. The prevalence of RBD is much higher in patients with neurodegenerative disorders, especially synucleinopathies. Within the past decade, a considerable body of research has demonstrated that retinal nerve fibers, as detected by optical coherence tomography (OCT), are altered in PD, dementia, multiple system atrophy (MSA), and other neurodegenerative diseases. However, less attention has been given to retinal alterations in RBD between PD and idiopathic RBD patients.

Methods: The REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) was used to classify PD patients with clinical probable RBD (PD+pRBD) or without probable RBD (PD-pRBD). Patients with iRBD were identified by polysomnography. All subjects underwent optical coherence tomography measurements for RNFL thickness.

Results: We found a significant decrease in the average RNFL thickness in patients with drug-naive PD and iRBD compared with healthy controls (all p<0.05). The average RNFL was dramatically thinner in the PD+pRBD group than the PD-pRBD group (p<0.005). Multiple linear regression analyses showed that RBDSQ score was negatively associated with average and inferior RNFL variation in PD (all p<0.005).

Conclusions: RNFL thickness seems to be thinning in idiopathic RBD. In PD, RNFL thickness may vary depending on the presence of RBD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/retinal-nerve-fiber-layer-thinning-a-window-into-rapid-eye-movement-sleep-behavior-disorders-in-parkinsons-disease/