Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder
Bibliographic record
Abstract
BACKGROUND: Idiopathic REM sleep behavior disorder (RBD) is characterized by loss of atonia during REM sleep, resulting in motor activity during dreams. Studies estimate that approximately half of patients with RBD will eventually develop Parkinson disease (PD), so RBD may be an indicator of presymptomatic PD. Several potential early diagnostic markers of PD have been proposed, but they have generally not been tested in presymptomatic PD. The authors hypothesized that these markers may be abnormal in idiopathic RBD. METHODS: The authors compared 25 patients with polysomnography-confirmed RBD without PD with age- and sex-matched controls. Color vision, olfaction, quantitative motor testing, and indices of depression, personality, and autonomic function were examined. RESULTS: Patients demonstrated significant impairment in color discrimination and olfactory function. Patients had subtle abnormalities on quantitative testing of motor and gait speed. Autonomic symptoms were more common in patients than controls. Abnormalities were heterogeneous, with some patients scoring normally on all domains, whereas others were severely impaired on multiple domains. Dysfunction on tests of olfactory function, color vision, and motor speed were highly correlated, such that patients who performed poorly on one test tended to perform poorly on the others. CONCLUSIONS: Many potential early markers of Parkinson disease are significantly abnormal in idiopathic REM sleep behavior disorder. These abnormalities are present in approximately half of the patients, suggesting a heterogenous pathophysiology.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".