{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:42:48Z","timestamp":1792219368626,"version":"4.4.0"},"reference-count":79,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["05162876"],"award-info":[{"award-number":["05162876"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["06170676"],"award-info":[{"award-number":["06170676"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accumulating evidence indicates that habitual diet, including plant\u2010based dietary patterns, is associated with neurodegenerative \u03b1\u2010synucleinopathy risk. However, the role of diet and its correlation with the gut microbiome in prodromal \u03b1\u2010synucleinopathy, specifically among patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD), remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate dietary patterns, their interplay with gut microbial dysbiosis, and longitudinal effects on neurodegenerative progression in iRBD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 287 iRBD patients and 208 age\u2010 and sex\u2010matched controls. Plant\u2010based diet indices (PDIs) were derived from food frequency questionnaires. Shotgun metagenomic sequencing was performed in 456 subjects for diet\u2013microbiome analyses. After a median follow\u2010up of 4.2\u2009years, 45 (15.7%) iRBD patients converted to \u03b1\u2010synucleinopathies. Cox proportional hazards models assessed the associations between diet and neurodegenerative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that iRBD patients exhibited lower healthful PDIs (adjusted odds ratio [aOR] 95% confidence interval [95% CI]: 0.48 [0.29\u20130.80],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) but higher consumption of unhealthful plant\u2010based foods (refined grains, sweets, and sweeteners). Diet\u2013microbiome interaction analysis identified dietary associations for 84.3% of iRBD\u2010related gut microbes, including co\u2010occurrence between healthful PDI and\n                      <jats:italic>Clostridium sp. AF20\u201017LB<\/jats:italic>\n                      . Longitudinally, four dietary factors and five iRBD\u2010related microbes were associated with neurodegenerative outcomes; specifically, higher coffee consumption was linked to a lower risk of progression to \u03b1\u2010synucleinopathy (aHR [95% CI]: 0.30 [0.11\u20130.78],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). Furthermore, mediation analyses indicated that the iRBD\u2010enriched species\n                      <jats:italic>Ruthenibacterium lactatiformans<\/jats:italic>\n                      mediated the association between unhealthful PDI and dementia\u2010first conversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Habitual diet in iRBD is associated with gut microbiome dysbiosis and predicts neurodegenerative progression. These findings highlight diet\u2013microbiome interactions as modifiable targets for intervention in prodromal \u03b1\u2010synucleinopathy. \u00a9 2026 The Author(s).\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                  <\/jats:sec>","DOI":"10.1002\/mds.70562","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:10:40Z","timestamp":1792217440000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Habitual Diet, Gut Microbiome Dysbiosis, and \u03b1\u2010Synucleinopathy Conversion in Isolated Rapid Eye Movement (\n                    <scp>REM)<\/scp>\n                    Sleep Behavior Disorder"],"prefix":"10.1002","author":[{"given":"Suyi","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhua","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR 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Guangdong Province and the Ministry of Education of China Guangzhou Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Center for Sleep and Circadian Medicine The Affiliated Brain Hospital, Guangzhou Medical University  Guangzhou China"},{"name":"Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul K.S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine The Chinese 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