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<p>Isolated REM sleep behaviour disorder (iRBD) represents a prodromal stage of alpha-synucleinopathies, frequently preceding Parkinson’s disease and dementia with Lewy bodies. Beyond the characteristic sleep disturbances, alterations in brain-body coupling, reflecting neural peripheral physiological interactions, have yet to be determined. Using whole-night polysomnography, we quantified brain-body coupling via heartbeat evoked potentials (HEPs) across wakefulness, NREM, and REM sleep. Individuals with iRBD (<i>n</i> = 13) were compared with healthy controls (<i>n</i> = 23), alongside analyses of ECG-derived features. During wakefulness, iRBD patients showed altered HEPs over frontal regions between 305 and 445 ms after the R-peak. No significant group differences were observed during NREM or REM sleep, and HEP amplitude alterations were not explained by ECG differences. These diurnal HEP changes may represent a novel quantitative biomarker for iRBD during wakefulness and, in the future, could serve as a marker for phenoconversion to alpha-synucleinopathy.</p>

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Altered heart-brain coupling in awake patients with isolated REM sleep behaviour disorder

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月23日

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  • Fosco Bernasconi,
  • Julia van der Meer,
  • Zehra Merchant,
  • Jevita Potheegadoo,
  • Marzia De Lucia,
  • Claudio Bassetti,
  • Carolin Schaefer,
  • Olaf Blanke

摘要

Isolated REM sleep behaviour disorder (iRBD) represents a prodromal stage of alpha-synucleinopathies, frequently preceding Parkinson’s disease and dementia with Lewy bodies. Beyond the characteristic sleep disturbances, alterations in brain-body coupling, reflecting neural peripheral physiological interactions, have yet to be determined. Using whole-night polysomnography, we quantified brain-body coupling via heartbeat evoked potentials (HEPs) across wakefulness, NREM, and REM sleep. Individuals with iRBD (n = 13) were compared with healthy controls (n = 23), alongside analyses of ECG-derived features. During wakefulness, iRBD patients showed altered HEPs over frontal regions between 305 and 445 ms after the R-peak. No significant group differences were observed during NREM or REM sleep, and HEP amplitude alterations were not explained by ECG differences. These diurnal HEP changes may represent a novel quantitative biomarker for iRBD during wakefulness and, in the future, could serve as a marker for phenoconversion to alpha-synucleinopathy.