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Whilst isolated RSWA (without DEB) was suggested as a prodrome of RBD, the implication of \u2018isolated\u2019 recurrent DEB remains under\u2010investigated. In this cross\u2010sectional study, we sought to investigate neurodegenerative markers amongst the first\u2010degree relatives (FDRs, aged &gt;40\u2009years) of patients with RBD who underwent clinical assessment for DEB, neurodegenerative markers, and video\u2010polysomnography assessment. Isolated recurrent DEB was defined as: (i) three or more episodes of DEB, (ii) had a DEB episode in the past 1\u2009year, and (iii) subthreshold RSWA. We identified 29 FDRs (mean [SD] age 53.4\u00a0[8.3]\u00a0years, 55.2% male) with isolated recurrent DEB and 98 age and sex\u2010matched FDRs as controls. Isolated DEB was associated with nightmare (27.6% versus 11.2%,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), and the DEB group had a higher rate of current smoking (27.6% versus 3.1%,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.006), type 2 diabetes mellitus (24.1% versus 10.2%,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), anxiety disorder (24.1% versus 11.2%,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), and constipation (hard lump of stool, 31.0% versus 7.1%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than the control group. The present findings revealed that family relatives of patients with RBD with isolated recurrent DEB have increased risk of RBD and neurodegenerative features, which adds to the emerging data that isolated DEB is a prodromal feature of RBD and \u03b1\u2010synucleinopathy neurodegeneration.<\/jats:p>","DOI":"10.1111\/jsr.13791","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T01:14:30Z","timestamp":1669079670000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Isolated dream\u2010enactment behaviours as a prodromal hallmark of rapid eye movement sleep behaviour disorder"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-4523","authenticated-orcid":false,"given":"Bei","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"},{"name":"Li 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Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"},{"name":"Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2986-8677","authenticated-orcid":false,"given":"Steven Wai Ho","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-2666","authenticated-orcid":false,"given":"Joey Wing Yan","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy Wai Man","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"},{"name":"Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7085-1850","authenticated-orcid":false,"given":"Shirley Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychology The University of Hong Kong Hong Kong China"},{"name":"The State Key Laboratory of Brain and Cognitive Sciences The University of Hong Kong Hong Kong 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