{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:56:36Z","timestamp":1793040996462,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Autonomic dysfunction is common across the \u03b1-synucleinopathies including isolated RBD (iRBD); however, the presence, severity, and distribution of autonomic dysfunction as a risk factor for phenoconversion in iRBD remains unclear. We aimed to characterize autonomic reflex testing (ART) abnormalities in a cohort of participants with iRBD and assess them as phenoconversion biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed ART on 45 individuals with iRBD and evaluated the ability of ART components (sympathetic cholinergic, cardiovagal, and sympathetic adrenergic) to predict phenoconversion using univariate and multivariate models combined with measures of olfaction, cognition, motor function, and skin biopsy assessment of dermal synuclein.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-one individuals with iRBD were enrolled (age 66.7\u2005\u00b1\u20057.4 years, 27% female), and followed annually for an average of 2.9\u2005\u00b1\u20052.4 years, with four participants lost to follow-up. Eight participants with iRBD phenoconverted during their follow-up period (three with Parkinson\u2019s disease, four with dementia with Lewy bodies, and one with multiple system atrophy), yielding a phenoconversion rate of 6.6% per year. Eighty-seven percent of iRBD participants had an abnormal baseline ART, and 100% had an abnormal follow-up ART. A combination of MDS-UPDRS III score and cardiovagal dysfunction (abnormal heart rate variability with deep breathing (HRVdb)) best-predicted phenoconversion (AUC = 0.77), especially when combined with iRBD disease duration (AUC = 0.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Autonomic nervous system dysfunction was common and spanned all domains of autonomic function. Cardiovagal function was the most common domain affected and most predictive of phenoconversion, especially if combined with motor examination and disease duration. Longitudinal studies with larger sample sizes are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsaf087","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T15:41:04Z","timestamp":1743349264000},"source":"Crossref","is-referenced-by-count":10,"title":["Frequency and longitudinal course of autonomic reflex testing abnormalities in isolated REM sleep behavior disorder"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3056-8878","authenticated-orcid":false,"given":"Hash Brown","family":"Taha","sequence":"first","affiliation":[{"name":"Department of Biochemistry & Molecular Medicine, Keck School of Medicine, University of Southern California , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-6185","authenticated-orcid":false,"given":"Jennifer","family":"Zitser","sequence":"additional","affiliation":[{"name":"Movement Disorders and Sleep Units, Department of Neurology, Tel Aviv Sourasky Medical Center, Affiliate of Sackler Faculty of Medicine, Tel-Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8488-0313","authenticated-orcid":false,"given":"Mitchell G","family":"Miglis","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University , Palo Alto, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"issue":"s1","key":"2025082001264290000_CIT0001","doi-asserted-by":"publisher","first-page":"S51","DOI":"10.3233\/JPD-179005","article-title":"The synucleinopathies: twenty years on","volume":"7","author":"Goedert","year":"2017","journal-title":"J Parkinsons Dis"},{"issue":"2","key":"2025082001264290000_CIT0002","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s11910-012-0253-z","article-title":"REM sleep behavior disorder and REM sleep without atonia as an early manifestation of degenerative neurological disease","volume":"12","author":"McCarter","year":"2012","journal-title":"Curr Neurol Neurosci Rep."},{"issue":"8","key":"2025082001264290000_CIT0003","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S1474-4422(21)00176-9","article-title":"Biomarkers of conversion to alpha-synucleinopathy in isolated rapid-eye-movement sleep behaviour disorder","volume":"20","author":"Miglis","year":"2021","journal-title":"Lancet Neurol."},{"issue":"1","key":"2025082001264290000_CIT0004","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1038\/s41572-018-0016-5","article-title":"REM sleep behaviour disorder","volume":"4","author":"Dauvilliers","year":"2018","journal-title":"Nat Rev Dis Primers."},{"issue":"1","key":"2025082001264290000_CIT0005","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/nrneurol.2017.157","article-title":"Idiopathic REM sleep behaviour disorder and neurodegeneration - 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