Advancing Research and Drug Development for Isolated RBD: Emmanuel During, MD

WATCH TIME: 5 minutes

"There’s a huge need for scalable, low-cost ways to monitor iRBD progression. Digital health tools—like wearables and cognitive apps—could be key to knowing when to intervene."

The research landscape for isolated REM sleep behavior disorder (iRBD) is rapidly evolving, as growing evidence links it to prodromal stages of neurodegenerative diseases, particularly Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. Longitudinal studies have shown that a significant proportion of patients with iRBD eventually convert to a synucleinopathy, making it a valuable biomarker for disease prediction and intervention.

At the 2025 SLEEP Annual Meeting, held June 8-11, in Seattle, Washington, several clinician leaders gave updates on biomarkers in RBD, focusing on neurophysiology, biofluid markers, and actigraphy. One of the presenters, Emmanuel During, MD, focused on research he and his colleagues conducted that validated the use of a novel antigraphy-based classifier that detects iRBD. Following the talk, During, an associate professor of neurology at the Icahn School of Medicine at Mount Sinai, sat down with NeurologyLive® to discuss the research landscape and potential therapeutic strategies to treat iRBD.

In the interview, During provided context on the need for scalable and low-cost monitoring solutions for iRBD, as well as the importance of prioritizing patients showing early signs of progression. In addition, he also highlighted the value of digital health tools, such as wearables and cognitive testing apps, as practical solutions for disease tracking. Furthermore, During provided clinical commentary on therapeutics for iRBD, noting that several promising agents —such as doxycycline, ambroxol, and GLP-1 receptor agonists—are being investigated for their potential neuroprotective effects, although clinical clarity remains limited.

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REFERENCE
1. Schenk CH, Boeve BF, Mahowald MW. Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: a 16-year update on a previously reported series. Sleep Med. 2013;14(8):744-8. doi:10.1016/j.sleep.2012.10.009