RBD Question of the Week❓💤💡 How confident are you in predicting phenoconversion/transformation of neurodegenerative conditions in people with RBD?

RBD Question of the Week❓💤💡

This week, we have Drs. Roneil Malkani from Northwestern University and Ron Postuma from McGill University to answer one of our most pressing RBD questions.

Q: How confident are you in predicting phenoconversion/transformation of neurodegenerative conditions in people with RBD?

A: Phenoconversion is the medical term that describes when a person who has RBD “converts” to a disorder such as Parkinson’s disease, dementia with Lewy bodies, or multiple system atrophy. While this term suggests a sudden change, i.e., when the neurological disorder is diagnosed, neurodegeneration is actually a gradual process that varies among people.

The phenoconversion rate is lower in younger patients (less than 50 years old) and probably increases by 1-2% each decade. In older patients with RBD, over age 65-70 years, phenoconversion rate is higher, about 6% every year. New data are emerging to help guide clinicians in predicting the risk, the timing of phenoconversion, and which disorder will develop. The presence of certain factors suggests a higher risk. The strongest of these factors include: changes in the neurological examination (memory or movement function), age, lightheadedness upon standing, frequent awakenings at night to urinate, loss of sense of smell, and acting out dreams with displacement out of bed. A brain imaging test that shows changes in brain dopamine levels may predict a higher risk of if phenoconversion. It is helpful to have a plan with your healthcare provider or a neurologist to monitor for development of these signs and development of neurological disorders over time.