Objective: In this study, we aimed to investigate the frequency of Rapid eye movement sleep behavior disorder (RBD) occurring in a large cohort of PSP, and the difference of clinical characteristics and tau deposition in vivo in patients with RBD compared to patients without RBD.

Background: RBD is often considered as a prodromal α-synucleinopathy. However, recent studies aroused that RBD was also found in non-αsynucleinopathy neurodegenerative diseases, including Alzheimer’s disease (AD) and progressive supranuclear palsy (PSP), indicating the possible involvement of tau pathology in RBD.

Method: We recruited patients with clinically diagnosed PSP from a precious study of Progressive Supranuclear Palsy Neuroimage Initiative (PSPNI), consecutively from May 2019 to January 2022. All the patients underwent clinical assessment including neuropsychological tests and the second-generation tau PET (¹⁸F-Florzolotau PET) scan.

Results: In the current study, 148 patients with PSP were finally included, with 27 patients as PSP presenting RBD symptom (18.2%). Compared to PSP patients without RBD, patients with RBD suffered from heavier disease severity. Meanwhile, more severe RBD symptoms assessed by REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) was relevant to PSPrs, Non-motor Symptoms Scale (NMSS) and Geriatric Depression (GDS), after the adjustment of age, education and levodopa equivalent daily dose. Additionally, PSP with RBD presented higher binding by ¹⁸F-Florzolotau PET semi-quantification analysis in locus coeruleus (LC) after the false discovery rate correction, which was also associated with RBDSQ.

Conclusion: Tau deposition in LC could lead to the presence of RBD in patients with PSP, usually accompanied with more heavier disease burden.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/tau-deposition-in-locus-coeruleus-is-associated-with-rapid-eye-movement-sleep-behavior-disorder-in-progressive-supranuclear-palsy/