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Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Isolated rapid eye movement sleep behavior disorder (iRBD) is a major prodromal marker of\n                    <jats:italic>\u03b1<\/jats:italic>\n                    -synucleinopathies, often preceding the clinical onset of Parkinson\u2019s disease, dementia with Lewy bodies, or multiple system atrophy. While wrist-worn actimeters hold significant potential for detecting RBD in large-scale screening efforts by capturing abnormal nocturnal movements, they require a reliable and efficient analysis pipeline. This study presents ActiTect, a fully automated, open-source machine learning tool to identify RBD from actigraphy recordings. To ensure generalizability across heterogeneous acquisition settings, our pipeline includes robust preprocessing and automated sleep-wake detection to harmonize multi-device data and extract physiologically interpretable motion features. Model development was conducted on a cohort of 78 individuals, yielding strong discrimination under nested cross-validation (AUROC\u2009=\u20090.95). Generalization was confirmed on a blinded local test set (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200931, AUROC\u2009=\u20090.86) and two independent external cohorts (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009113, AUROC\u2009=\u20090.84;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200957, AUROC\u2009=\u20090.94). To assess robustness, leave-one-dataset-out cross-validation across cohorts demonstrated consistent performance (AUROC range\u2009=\u20090.84\u20130.89). Complementary stability analysis showed that predictive features remained reproducible across datasets, supporting the pooled multi-center pre-trained model for broader deployment. As an open-source, easy-to-use tool, ActiTect promotes adoption, independent validation, and collaborative improvements, thereby advancing generalizable wearable-based RBD detection.\n                  <\/jats:p>","DOI":"10.1038\/s41746-026-02738-8","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T22:24:06Z","timestamp":1781303046000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["ActiTect: a generalizable machine learning pipeline for REM sleep behavior disorder screening through standardized actigraphy"],"prefix":"10.1038","volume":"9","author":[{"given":"David","family":"Bertram","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Ophey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinah","family":"R\u00f6ttgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Kufer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Merten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gereon R.","family":"Fink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Kalbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clint","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Maetzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Kapsecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara M.","family":"Reimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Jonas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas T.","family":"Damgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha B.","family":"Bertelsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casper","family":"Skjaerbaek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Borghammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolien","family":"Groenewald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro-Luca","family":"Ratti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele T.","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"No\u00e9mie","family":"Moreau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sommerauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Bozek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"2738_CR1","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/S1474-4422(19)30411-9","volume":"19","author":"VL Feigin","year":"2020","unstructured":"Feigin, V. 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