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The North American Prodromal Synucleinopathy (NAPS) Consortium was established to address these challenges and facilitate clinical trials for neuroprotective therapies targeting synucleinopathy at the earliest known stages. In this multi-site, longitudinal, observational study, nine academic centers across North America will enroll and follow over 500 individuals with iRBD from existing sleep centers. Sixty control participants, matched for age, sex, and race will also be recruited. A harmonized protocol\u2014including a standardized clinical battery assessing motor, cognitive, autonomic, psychiatric, sensory, and sleep function; structured diagnostic adjudication; biospecimen collection; and centralized analysis of both polysomnography and neuroimaging data\u2014is outlined herein and reflects NAPS Stage 2. Each participants completes these assessments annually, and are replaced in the event of phenoconversion. By unifying assessments and expanding geographic reach, NAPS lays the groundwork for efficient, well-powered clinical trials designed to delay or prevent progression of iRBD to overt PD, DLB, or MSA\u2014ultimately enabling earlier, more effective therapeutic intervention for neurodegenerative disease. Registered at clinicaltrials.gov (NCT05826457).<\/jats:p>","DOI":"10.1093\/sleepadvances\/zpag007","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T12:30:29Z","timestamp":1768653029000},"source":"Crossref","is-referenced-by-count":4,"title":["The North American Prodromal Synucleinopathy study: protocol for a multi-site, longitudinal, observational study of idiopathic\/isolated rapid eye movement sleep behavior disorder"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3876-3196","authenticated-orcid":false,"given":"Miranda M","family":"Lim","sequence":"first","affiliation":[{"name":"Research Service, VA Portland Health Care System , Portland, OR ,","place":["United States"]},{"name":"Department of Neurology, Oregon Health and Science University , Portland, OR ,","place":["United 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