{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:40:32Z","timestamp":1788504032642,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dopamine transporter single photon\u2010emission computed tomography (DAT\u2010SPECT) is the strongest risk factor for phenoconversion in patients with idiopathic rapid eye movement (REM)\u2010sleep behavior disorder (iRBD). However, it might be used as a second\u2010line stratification tool in clinical trials, because it is expensive and mini\u2010invasive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Aim of the study is to investigate whether other cost\u2010effective and non\u2010invasive biomarkers may be proposed as first\u2010line stratification tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010seven consecutive iRBD patients (68.53\u2009\u00b1\u20097.16\u2009years, 40 males) underwent baseline clinical and neuropsychological assessment, olfaction test, resting electroencephalogram (EEG), and DAT\u2010SPECT. All patients underwent 6\u2009month\u2010based clinical follow\u2010up to investigate the emergence of parkinsonism and\/or dementia. Survival analysis and Cox regression were used to estimate conversion risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen patients developed an overt synucleinopathy (eight Parkinsonism and nine dementia) 32.8\u2009\u00b1\u200922\u2009months after diagnosis. The strongest risk factors were putamen specific to non\u2010displaceable binding ratio (SBR) (hazard ratio [HR], 7.3), attention\/working memory cognitive function (NPS\u2010AT\/WM) (HR, 5.9), EEG occipital mean frequency (HR, 2.7) and clinical motor assessment (HR, 2.3). On multivariate Cox\u2010regression analysis, only putamen SBR and NPS\u2010AT\/WM significantly contributed to the model (HR, 6.2, 95% confidence interval [CI], 1.9\u201319.8). At post\u2010hoc analysis, the trail\u2010making test B (TMT\u2010B) was the single most efficient first\u2010line stratification tool that allowed to reduce the number of eligible subjects to 76.6% (sensitivity 1, specificity 0.37). Combining TMT\u2010B and DAT\u2010SPECT further reduced the sample to 66% (sensitivity 0.88, specificity 0.47).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The TMT\u2010B seems to be a cost\u2010effective and efficient first\u2010line screening tool, to be used to select patients that deserve DAT\u2010SPECT as second\u2010line screening tool for disease\u2010modifying clinical trials. \u00a9 2021 The Authors.\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society\n                    <\/jats:p>\n                  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