{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:41:02Z","timestamp":1791841262105,"version":"4.3.4"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100013937","name":"Thiemann Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013937","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024583","name":"Medizinische Fakult\u00e4t, Universit\u00e4t zu K\u00f6ln","doi-asserted-by":"publisher","award":["Koeln Fortune Program 329\/2021"],"award-info":[{"award-number":["Koeln Fortune Program 329\/2021"]}],"id":[{"id":"10.13039\/501100024583","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Novartis\u2010Stiftung f\u00fcr therapeutische Forschung"},{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Accelerometry enables passive, continuous, high-frequency monitoring under free-living conditions. For individuals with isolated REM sleep behavior disorder (iRBD), a potential prodromal phase of Parkinson\u2019s disease (PD) and dementia with Lewy bodies, accelerometry has been primarily applied to aid diagnosis and to assess phenoconversion risk. To extend this knowledge, we cross-sectionally combined clinical assessments focusing on non-motor symptoms with accelerometry-derived features of physical activity (PA), sleep, and circadian rhythm of <jats:italic>N<\/jats:italic>\u2009=\u200968 individuals with iRBD (age: 69.48\u2009\u00b1\u20096.01 years, self-reported\u00a0RBD symptom duration: 9.46\u2009\u00b1\u20096.21 years, 85\u00a0% male). Accelerometry-assessed PA was associated with more stable circadian rhythms. Additionally, higher PA and more stable circadian rhythms were linked to a lower burden of overall non-motor symptoms, depressive symptoms, and fatigue with small to moderate effect sizes. Furthermore, including accelerometry-derived features improved the prediction of individual clinical scores, particularly for cognitive performance. Our findings contribute to the growing body of evidence highlighting the complex interplay between PA, sleep, circadian rhythm, and non-motor symptoms in \u03b1-synucleinopathies. Future research should focus on longitudinal studies to monitor changes in clinical outcomes and digital biomarkers over time to enhance our understanding of symptom progression and corresponding lifestyle changes in prodromal and manifest \u03b1-synucleinopathies.<\/jats:p>","DOI":"10.1007\/s00415-025-12931-6","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T18:43:30Z","timestamp":1739299410000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Accelerometry-derived features of physical activity, sleep and circadian rhythm relate to non-motor symptoms in individuals with isolated REM sleep behavior disorder"],"prefix":"10.1007","volume":"272","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5858-7762","authenticated-orcid":false,"given":"Anja","family":"Ophey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2951-2208","authenticated-orcid":false,"given":"Vaishali","family":"Vinod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7553-2111","authenticated-orcid":false,"given":"Sinah","family":"R\u00f6ttgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2781-3143","authenticated-orcid":false,"given":"Daniel","family":"Scharfenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-1856","authenticated-orcid":false,"given":"Gereon R.","family":"Fink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5723-9766","authenticated-orcid":false,"given":"Michael","family":"Sommerauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-2545","authenticated-orcid":false,"given":"Elke","family":"Kalbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5945-4694","authenticated-orcid":false,"given":"Walter","family":"Maetzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-3868","authenticated-orcid":false,"given":"Clint","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"issue":"2","key":"12931_CR1","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1093\/brain\/awab431","volume":"145","author":"I Poggiolini","year":"2022","unstructured":"Poggiolini I et al (2022) Diagnostic value of cerebrospinal fluid alpha-synuclein seed quantification in synucleinopathies. Brain 145(2):584\u2013595. https:\/\/doi.org\/10.1093\/brain\/awab431","journal-title":"Brain"},{"key":"12931_CR2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29340","author":"A Kuzkina","year":"2023","unstructured":"Kuzkina A et al (2023) Dermal real\u2010time quaking\u2010induced conversion is a sensitive marker to confirm isolated rapid eye movement sleep behavior disorder as an early \u03b1\u2010synucleinopathy.\u00a0Mov Disord. https:\/\/doi.org\/10.1002\/mds.29340","journal-title":"Mov Disord"},{"issue":"8","key":"12931_CR3","doi-asserted-by":"publisher","first-page":"3258","DOI":"10.1093\/brain\/awad072","volume":"146","author":"S Joza","year":"2023","unstructured":"Joza S et al (2023) Progression of clinical markers in prodromal Parkinson\u2019s disease and dementia with Lewy bodies: a multicentre study. Brain 146(8):3258\u20133272https:\/\/doi.org\/10.1093\/brain\/awad072","journal-title":"Brain"},{"issue":"3","key":"12931_CR4","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1093\/brain\/awz030","volume":"142","author":"RB Postuma","year":"2019","unstructured":"Postuma RB et al (2019) Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 142(3):744\u2013759. https:\/\/doi.org\/10.1093\/brain\/awz030","journal-title":"Brain"},{"issue":"1","key":"12931_CR5","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1002\/mds.29662","volume":"39","author":"C Di Folco","year":"2024","unstructured":"Di Folco C et al (2024) Charting disease trajectories from isolated rem sleep behavior disorder to Parkinson\u2019s disease. Mov Disord 39(1):64\u201375. https:\/\/doi.org\/10.1002\/mds.29662","journal-title":"Mov Disord"},{"key":"12931_CR6","doi-asserted-by":"publisher","DOI":"10.1177\/1877718X241310726","author":"S R\u00f6ttgen","year":"2025","unstructured":"R\u00f6ttgen S, Lindner M-S, Seger A et al (2025) Non-motor symptoms in prodromal Parkinson\u2019s disease are linked to reduced quality of life. J Parkinson\u2019s Dis 0(0). https:\/\/doi.org\/10.1177\/1877718X241310726","journal-title":"J Parkinson\u2019s Dis"},{"issue":"1","key":"12931_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.parkreldis.2010.08.012","volume":"17","author":"S-E Soh","year":"2011","unstructured":"Soh S-E, Morris ME, McGinley JL (2011) Determinants of health-related quality of life in Parkinson\u2019s disease: a systematic review. Parkinsonism Relat Disord 17(1):1\u20139. https:\/\/doi.org\/10.1016\/j.parkreldis.2010.08.012","journal-title":"Parkinsonism Relat Disord"},{"issue":"3","key":"12931_CR8","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/mds.23462","volume":"26","author":"P Martinez-Martin","year":"2011","unstructured":"Martinez-Martin P et al (2011) The impact of non-motor symptoms on health-related quality of life of patients with Parkinson\u2019s disease. Mov Disord 26(3):399\u2013406. https:\/\/doi.org\/10.1002\/mds.23462","journal-title":"Mov Disord"},{"key":"12931_CR9","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.parkreldis.2021.07.032","volume":"89","author":"DJ van Wamelen","year":"2021","unstructured":"van Wamelen DJ et al (2021) Digital health technology for non-motor symptoms in people with Parkinson\u2019s disease: futile or future? Parkinsonism Relat Disord 89:186\u2013194. https:\/\/doi.org\/10.1016\/j.parkreldis.2021.07.032","journal-title":"Parkinsonism Relat Disord"},{"issue":"1","key":"12931_CR10","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1038\/s41746-024-01144-2","volume":"7","author":"JM Janssen Daalen","year":"2024","unstructured":"Janssen Daalen JM et al (2024) Digital biomarkers for non-motor symptoms in Parkinson\u2019s disease: the state of the art. NPJ Digit Med 7(1):186. https:\/\/doi.org\/10.1038\/s41746-024-01144-2","journal-title":"NPJ Digit Med"},{"issue":"1","key":"12931_CR11","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1038\/s41746-022-00568-y","volume":"5","author":"AS Chandrabhatla","year":"2022","unstructured":"Chandrabhatla AS, Pomeraniec IJ, Ksendzovsky A (2022) Co-evolution of machine learning and digital technologies to improve monitoring of Parkinson\u2019s disease motor symptoms. NPJ Digit Med 5(1):32. https:\/\/doi.org\/10.1038\/s41746-022-00568-y","journal-title":"NPJ Digit Med"},{"issue":"3","key":"12931_CR12","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1159\/000503957","volume":"3","author":"P Coran","year":"2019","unstructured":"Coran P et al (2019) Advancing the use of mobile technologies in clinical trials: recommendations from the clinical trials transformation initiative. Digit Biomark 3(3):145\u2013154. https:\/\/doi.org\/10.1159\/000503957","journal-title":"Digit Biomark"},{"issue":"8","key":"12931_CR13","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.1038\/s41591-023-02440-2","volume":"29","author":"AK Schalkamp","year":"2023","unstructured":"Schalkamp AK et al (2023) Wearable movement-tracking data identify Parkinson\u2019s disease years before clinical diagnosis. Nat Med 29(8):2048\u20132056. https:\/\/doi.org\/10.1038\/s41591-023-02440-2","journal-title":"Nat Med"},{"key":"12931_CR14","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsad030","author":"O Gnarra","year":"2023","unstructured":"Gnarra O et al (2023) Rapid eye movement sleep behavior disorder: a narrative review from a technological perspective. Sleep. https:\/\/doi.org\/10.1093\/sleep\/zsad030","journal-title":"Sleep"},{"issue":"10","key":"12931_CR15","doi-asserted-by":"publisher","first-page":"1848","DOI":"10.1111\/ene.14386","volume":"27","author":"M Filardi","year":"2020","unstructured":"Filardi M et al (2020) Objective rest-activity cycle analysis by actigraphy identifies isolated rapid eye movement sleep behavior disorder. Eur J Neurol 27(10):1848\u20131855. https:\/\/doi.org\/10.1111\/ene.14386","journal-title":"Eur J Neurol"},{"issue":"6","key":"12931_CR16","doi-asserted-by":"publisher","first-page":"zsy053","DOI":"10.1093\/sleep\/zsy053","volume":"41","author":"A Stefani","year":"2018","unstructured":"Stefani A et al (2018) Screening for idiopathic REM sleep behavior disorder: usefulness of actigraphy. Sleep 41(6):zsy053. https:\/\/doi.org\/10.1093\/sleep\/zsy053","journal-title":"Sleep"},{"issue":"1","key":"12931_CR17","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1002\/mds.29249","volume":"38","author":"A Brink-Kjaer","year":"2023","unstructured":"Brink-Kjaer A et al (2023) Ambulatory detection of isolated rapid-eye-movement sleep behavior disorder combining actigraphy and questionnaire. Mov Disord 38(1):82\u201391. https:\/\/doi.org\/10.1002\/mds.29249","journal-title":"Mov Disord"},{"issue":"4","key":"12931_CR18","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1002\/ana.25853","volume":"88","author":"H Feng","year":"2020","unstructured":"Feng H et al (2020) Rest-activity pattern alterations in idiopathic REM sleep behavior disorder. Ann Neurol 88(4):817\u2013829. https:\/\/doi.org\/10.1002\/ana.25853","journal-title":"Ann Neurol"},{"issue":"1","key":"12931_CR19","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/s41531-024-00719-w","volume":"10","author":"AK Schalkamp","year":"2024","unstructured":"Schalkamp AK et al (2024) Digital outcome measures from smartwatch data relate to non-motor features of Parkinson\u2019s disease. NPJ Parkinsons Dis 10(1):110. https:\/\/doi.org\/10.1038\/s41531-024-00719-w","journal-title":"NPJ Parkinsons Dis"},{"key":"12931_CR20","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","volume":"386","author":"LV Kalia","year":"2015","unstructured":"Kalia LV, Lang AE (2015) Parkinson\u2019s disease. The Lancet 386:896\u2013912. https:\/\/doi.org\/10.1016\/S0140-6736(14)61393-3","journal-title":"The Lancet"},{"issue":"10","key":"12931_CR21","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1002\/mds.27802","volume":"34","author":"S Heinzel","year":"2019","unstructured":"Heinzel S et al (2019) Update of the MDS research criteria for prodromal Parkinson\u2019s disease. Mov Disord 34(10):1464\u20131470. https:\/\/doi.org\/10.1002\/mds.27802","journal-title":"Mov Disord"},{"issue":"3","key":"12931_CR22","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1123\/jmpb.2018-0063","volume":"2","author":"JH Migueles","year":"2019","unstructured":"Migueles JH et al (2019) GGIR: a research community-driven open source R package for generating physical activity and sleep outcomes from multi-day raw accelerometer data. J Measure Phys Behav 2(3):188\u2013196. https:\/\/doi.org\/10.1123\/jmpb.2018-0063","journal-title":"J Measure Phys Behav"},{"issue":"102","key":"12931_CR23","doi-asserted-by":"publisher","first-page":"6842","DOI":"10.21105\/joss.06842","volume":"9","author":"M Abedinifar","year":"2024","unstructured":"Abedinifar M et al (2024) KielMAT: Kiel motion analysis toolbox\u2014an open-source python toolbox for analyzing neurological motion data from various recording modalities. J Open Source Softw 9(102):6842. https:\/\/doi.org\/10.21105\/joss.06842","journal-title":"J Open Source Softw"},{"issue":"1","key":"12931_CR24","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1186\/s13063-024-08265-9","volume":"25","author":"A Ophey","year":"2024","unstructured":"Ophey A et al (2024) Cognitive training and promoting a healthy lifestyle for individuals with isolated REM sleep behavior disorder: study protocol of the delayed-start randomized controlled trial CogTrAiL-RBD. Trials 25(1):428. https:\/\/doi.org\/10.1186\/s13063-024-08265-9","journal-title":"Trials"},{"key":"12931_CR25","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29389","author":"A Seger","year":"2023","unstructured":"Seger A et al (2023) Evaluation of a structured screening assessment to detect isolated rapid eye movement sleep behavior disorder. Movement Disord. https:\/\/doi.org\/10.1002\/mds.29389","journal-title":"Movement Disord"},{"issue":"4","key":"12931_CR26","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","volume":"53","author":"ZS Nasreddine","year":"2005","unstructured":"Nasreddine ZS et al (2005) The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53(4):695\u2013699","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"12931_CR27","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1002\/mds.24893","volume":"27","author":"I Litvan","year":"2012","unstructured":"Litvan I et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson\u2019s disease: movement disorder society task force guidelines. Mov Disord 27(3):349\u2013356","journal-title":"Mov Disord"},{"issue":"7","key":"12931_CR28","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1002\/mds.20844","volume":"21","author":"KR Chaudhuri","year":"2006","unstructured":"Chaudhuri KR et al (2006) International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson\u2019s disease: the NMSQuest study. Movement Disord 21(7):916\u2013923","journal-title":"Movement Disord"},{"issue":"12","key":"12931_CR29","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1177\/1352458509348519","volume":"15","author":"I-K Penner","year":"2009","unstructured":"Penner I-K et al (2009) The fatigue scale for motor and cognitive functions (FSMC): validation of a new instrument to assess multiple sclerosis-related fatigue. Mult Scler J 15(12):1509\u20131517","journal-title":"Mult Scler J"},{"issue":"2","key":"12931_CR30","first-page":"490","volume":"78","author":"AT Beck","year":"1996","unstructured":"Beck AT, Steer RA, Brown GK (1996) Beck depression inventory-II. San Antonio 78(2):490\u2013498","journal-title":"San Antonio"},{"issue":"4","key":"12931_CR31","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1002\/mds.23476","volume":"26","author":"C Trenkwalder","year":"2011","unstructured":"Trenkwalder C et al (2011) Parkinson\u2019s disease sleep scale\u2014validation of the revised version PDSS-2. Mov Disord 26(4):644\u2013652","journal-title":"Mov Disord"},{"issue":"16","key":"12931_CR32","doi-asserted-by":"publisher","first-page":"2386","DOI":"10.1002\/mds.21740","volume":"22","author":"K Stiasny-Kolster","year":"2007","unstructured":"Stiasny-Kolster K et al (2007) The REM sleep behavior disorder screening questionnaire\u2014a new diagnostic instrument. Mov Disord 22(16):2386\u20132393","journal-title":"Mov Disord"},{"issue":"3","key":"12931_CR33","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1037\/h0061266","volume":"32","author":"J Tiffin","year":"1948","unstructured":"Tiffin J, Asher EJ (1948) The Purdue Pegboard: norms and studies of reliability and validity. J Appl Psychol 32(3):234","journal-title":"J Appl Psychol"},{"issue":"15","key":"12931_CR34","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","volume":"23","author":"CG Goetz","year":"2008","unstructured":"Goetz CG et al (2008) Movement disorder society-sponsored revision of the unified Parkinson\u2019s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Movement Disord 23(15):2129\u20132170","journal-title":"Movement Disord"},{"key":"12931_CR35","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1007\/s10072-018-3564-2","volume":"39","author":"E Zirek","year":"2018","unstructured":"Zirek E et al (2018) Which cognitive dual-task walking causes most interference on the timed up and go test in Parkinson\u2019s disease: a controlled study. Neurol Sci 39:2151\u20132157","journal-title":"Neurol Sci"},{"key":"12931_CR36","unstructured":"R Core Team, R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https:\/\/www.R-project.org\/. 2023: Vienna, Austria."},{"issue":"7","key":"12931_CR37","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1152\/japplphysiol.00421.2014","volume":"117","author":"VT van Hees","year":"2014","unstructured":"van Hees VT et al (2014) Autocalibration of accelerometer data for free-living physical activity assessment using local gravity and temperature: an evaluation on four continents. J Appl Physiol 117(7):738\u2013744. https:\/\/doi.org\/10.1152\/japplphysiol.00421.2014","journal-title":"J Appl Physiol"},{"issue":"11","key":"12931_CR38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142533","volume":"10","author":"VT van Hees","year":"2015","unstructured":"van Hees VT et al (2015) A novel, open access method to assess sleep duration using a wrist-worn accelerometer. PLoS ONE 10(11):e0142533. https:\/\/doi.org\/10.1371\/journal.pone.0142533","journal-title":"PLoS ONE"},{"issue":"1","key":"12931_CR39","doi-asserted-by":"publisher","first-page":"12975","DOI":"10.1038\/s41598-018-31266-z","volume":"8","author":"VT van Hees","year":"2018","unstructured":"van Hees VT et al (2018) Estimating sleep parameters using an accelerometer without sleep diary. Sci Rep 8(1):12975. https:\/\/doi.org\/10.1038\/s41598-018-31266-z","journal-title":"Sci Rep"},{"issue":"1","key":"12931_CR40","doi-asserted-by":"publisher","first-page":"3216","DOI":"10.1038\/s41598-017-03171-4","volume":"7","author":"AJK Phillips","year":"2017","unstructured":"Phillips AJK et al (2017) Irregular sleep\/wake patterns are associated with poorer academic performance and delayed circadian and sleep\/wake timing. Sci Rep 7(1):3216. https:\/\/doi.org\/10.1038\/s41598-017-03171-4","journal-title":"Sci Rep"},{"issue":"4","key":"12931_CR41","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/0006-3223(95)00370-3","volume":"40","author":"EJ van Someren","year":"1996","unstructured":"van Someren EJ et al (1996) Circadian rest-activity rhythm disturbances in Alzheimer\u2019s disease. Biol Psychiatry 40(4):259\u2013270. https:\/\/doi.org\/10.1016\/0006-3223(95)00370-3","journal-title":"Biol Psychiatry"},{"issue":"4","key":"12931_CR42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0061691","volume":"8","author":"VT van Hees","year":"2013","unstructured":"van Hees VT et al (2013) Separating movement and gravity components in an acceleration signal and implications for the assessment of human daily physical activity. PLoS ONE 8(4):e61691. https:\/\/doi.org\/10.1371\/journal.pone.0061691","journal-title":"PLoS ONE"},{"key":"12931_CR43","doi-asserted-by":"publisher","DOI":"10.3389\/frsle.2023.1286124","author":"JR Winer","year":"2023","unstructured":"Winer JR et al (2023) Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures. Front Sleep. https:\/\/doi.org\/10.3389\/frsle.2023.1286124","journal-title":"Front Sleep"},{"key":"12931_CR44","doi-asserted-by":"publisher","first-page":"S281","DOI":"10.3233\/JPD-191721","volume":"9","author":"P Borghammer","year":"2019","unstructured":"Borghammer P, Van Den Berge N (2019) Brain-first versus gut-first Parkinson\u2019s disease: a hypothesis. J Parkinsons Dis 9:S281\u2013S295. https:\/\/doi.org\/10.3233\/JPD-191721","journal-title":"J Parkinsons Dis"},{"key":"12931_CR45","doi-asserted-by":"publisher","first-page":"106101","DOI":"10.1016\/j.parkreldis.2024.106101","volume":"122","author":"J Horsager","year":"2024","unstructured":"Horsager J, Borghammer P (2024) Brain-first vs body-first Parkinson\u2019s disease: an update on recent evidence. Parkinsonism Related Dis 122:106101. https:\/\/doi.org\/10.1016\/j.parkreldis.2024.106101","journal-title":"Parkinsonism Related Dis"},{"issue":"2","key":"12931_CR46","doi-asserted-by":"publisher","first-page":"133","DOI":"10.5664\/jcsm.1762","volume":"8","author":"C White","year":"2012","unstructured":"White C et al (2012) Diagnostic delay in REM sleep behavior disorder (RBD). J Clin Sleep Med 8(2):133\u2013136. https:\/\/doi.org\/10.5664\/jcsm.1762","journal-title":"J Clin Sleep Med"},{"issue":"1","key":"12931_CR47","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1038\/s41531-023-00598-7","volume":"9","author":"A Seger","year":"2023","unstructured":"Seger A et al (2023) Clinical subtypes in patients with isolated REM sleep behaviour disorder. Parkinson\u2019s Dis 9(1):155. https:\/\/doi.org\/10.1038\/s41531-023-00598-7","journal-title":"Parkinson's Dis"},{"key":"12931_CR48","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.sleep.2024.03.025","volume":"118","author":"V Vinod","year":"2024","unstructured":"Vinod V et al (2024) Objectively assessed sleep quality parameters in Multiple Sclerosis at home: association to disease, disease severity and physical activity. Sleep Med 118:71\u201377. https:\/\/doi.org\/10.1016\/j.sleep.2024.03.025","journal-title":"Sleep Med"},{"issue":"6","key":"12931_CR49","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.sleh.2023.07.016","volume":"9","author":"TL Sletten","year":"2023","unstructured":"Sletten TL et al (2023) The importance of sleep regularity: a consensus statement of the national sleep foundation sleep timing and variability panel. Sleep Health 9(6):801\u2013820. https:\/\/doi.org\/10.1016\/j.sleh.2023.07.016","journal-title":"Sleep Health"},{"issue":"1","key":"12931_CR50","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s44167-023-00040-6","volume":"3","author":"L Nauha","year":"2024","unstructured":"Nauha L et al (2024) Regularity of bedtime, wake-up time, and time in bed in mid-life: associations with cardiometabolic health markers with adjustment for physical activity and sedentary time. J Activity Sedentary Sleep Behav 3(1):2. https:\/\/doi.org\/10.1186\/s44167-023-00040-6","journal-title":"J Activity Sedentary Sleep Behav"},{"issue":"1","key":"12931_CR51","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1038\/s41746-024-01135-3","volume":"7","author":"F Lin","year":"2024","unstructured":"Lin F et al (2024) Association of physical activity pattern and risk of Parkinson\u2019s disease. NPJ Dig Med 7(1):137. https:\/\/doi.org\/10.1038\/s41746-024-01135-3","journal-title":"NPJ Dig Med"},{"key":"12931_CR52","doi-asserted-by":"publisher","DOI":"10.1177\/02692155241272967","author":"A Still","year":"2024","unstructured":"Still A et al (2024) Relationships between physical activities performed under free-living conditions and non-motor symptoms in people with Parkinson\u2019s: a systematic review and meta-analysis. Clin Rehabil. https:\/\/doi.org\/10.1177\/02692155241272967","journal-title":"Clin Rehabil"},{"issue":"8","key":"12931_CR53","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1002\/mds.26731","volume":"31","author":"R Mart\u00ednez-Fern\u00e1ndez","year":"2016","unstructured":"Mart\u00ednez-Fern\u00e1ndez R et al (2016) The hidden sister of motor fluctuations in Parkinson\u2019s disease: a review on nonmotor fluctuations. Mov Disord 31(8):1080\u20131094. https:\/\/doi.org\/10.1002\/mds.26731","journal-title":"Mov Disord"},{"issue":"1","key":"12931_CR54","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.sleep.2009.06.008","volume":"11","author":"SX Li","year":"2010","unstructured":"Li SX et al (2010) Validation of a new REM sleep behavior disorder questionnaire (RBDQ-HK). Sleep Med 11(1):43\u201348","journal-title":"Sleep Med"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-12931-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-025-12931-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-12931-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T17:42:45Z","timestamp":1742233365000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-025-12931-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["12931"],"URL":"https:\/\/doi.org\/10.1007\/s00415-025-12931-6","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,11]]},"assertion":[{"value":"19 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethics committee of the Faculty of Medicine of the University of Cologne approved the study (Identifier: 21\u20131291). The clinical trial [] was conducted following the principles outlined in the Declaration of Helsinki and prospectively registered in the German Clinical Trial Register (DRKS00024898). All participants gave written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"AO received grants from the Koeln Fortune Program (grant-no. 329\/2021, 142\/2023), Faculty of Medicine, University of Cologne, and the \u201cNovartis-Stiftung f\u00fcr therapeutische Forschung\u201d, and a scholarship within the Thiemann Visitor Program of the Prof. Klaus Thiemann Stiftung. VV has no conflict of interest. SR received a scholarship within the Thiemann Visitor Program of the Prof. Klaus Thiemann Stiftung. DS receives a doctoral scholarship from the German Academic Scholarship Foundation outside the submitted work and declares no non-financial competing interests. GRF serves as an editorial board member of Cortex, Neurological Research and Practice, NeuroImage: Clinical, Zeitschrift f\u00fcr Neuropsychologie, and Info Neurologie & Psychiatrie; receives royalties from the publication of the books Funktionelle MRT in Psychiatrie und Neurologie, Neurologische Differentialdiagnose, SOP Neurologie, and Therapiehandbuch Neurologie; receives royalties from the publication of the neuropsychological tests KAS and K\u00f6pps; received honoraria for speaking engagements from Deutsche Gesellschaft f\u00fcr Neurologie (DGN) and Forum f\u00fcr medizinische Fortbildung FomF GmbH; receives funding from the Deutsche Forschungsgemeinschaft (CRC 1451; Project-ID 431549029). MS received grants from the Else Kr\u00f6ner-Fresenius-Stiftung (grant number 2019_EKES.02). MS is receiving funding from the program \"Netzwerke 2021\", an initiative of the Ministry of Culture and Science of the State of Northrhine Westphalia. The Federal Ministry of Education and Research (BMBF) is funded within the framework of the funding programme ACCENT (funding code 01EO2107. EK received grants from the German Ministry of Education and Research, the Joint Federal Committee, and The German Parkinson Foundation, all outside the submitted work. EK received honoraria from the companies EISAI GmbH, Germany, memodio GmbH, Germany, Desitin GmbH, Germany, and Prolog GmbH, Germany, all outside the submitted work. WM has no conflict of interest. CH has no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"201"}}