Elevated plasma neurofilament light chain in isolated REM sleep behavior disorder: Associations with neurogenic orthostatic hypotension and implications for phenoconversion
counterparts, with values overlapping PD and MSA. nOH was inversely associated with hyposmia, supporting phenotypic divergence. NfL correlated positively with SCOPA-AUT and BDI scores. At follow-up, all four MSA converters had nOH at baseline.ConclusionsPlasma NfL elevation in iRBD supports its role as a marker of early neurodegeneration. Its association with nOH suggests that this autonomic feature may identify a biologically more severe iRBD phenotype, possibly on a trajectory toward MSA. These findings warrant extended longitudinal validation and support the integration of clinical and biological markers, including NfL, for stratifying conversion risk.
Authors
- Stella Gagliardi (ORCID: https://orcid.org/0000-0002-6589-6907)
- Piergiorgio Grillo (ORCID: https://orcid.org/0000-0001-8196-3914)
- Alessandra Calculli
- Gabriele Bellini (ORCID: https://orcid.org/0000-0002-0648-6836)
- Simone Regalbuto (ORCID: https://orcid.org/0009-0001-3783-5365)
- Silvia Cerri (ORCID: https://orcid.org/0000-0002-6466-5381)
- Elena Capriglia (ORCID: https://orcid.org/0009-0008-1109-2285)
- Michelangelo Maestri (ORCID: https://orcid.org/0000-0003-0960-4938)
- D. Di Martino (ORCID: https://orcid.org/0009-0007-8445-8535)
- Gaetano Malomo
- Michele Terzaghi
- Davide Comolli
- Antonio Pisani
- Roberto Ceravolo
- Domeniko Hoxhaj
- Enrica Bonanni
- Carlo Fazio
Institutions
- University of Pisa (IT)
- AOL (United States) (US)
- University of Pavia (IT)
Publication Details
- Journal
- Journal of Parkinson s Disease
- Published
- 2026-04-15
- DOI
- https://doi.org/10.1177/1877718x261418988
- Primary Topic
- Parkinson's Disease Mechanisms and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00