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REM Sleep Behavior Disorder and the Syn-One Test®: The Syn-Sleep Study Explores an Early Warning Sign for Parkinson’s and Related Conditions

By April 22, 2024No Comments

REM Sleep Behavior Disorder and the Syn-One Test®: The Syn-Sleep Study Explores an Early Warning Sign for Parkinson’s and Related Conditions

On the heels of the highly anticipated publication of the NIH-supported Synuclein-One Study in JAMA1, the research team at CND Life Sciences, along with several specialty centers around the country, continue to explore the potential for the Syn-One Test with two additional NIH-supported clinical trials. The Syn-D Study will focus on the Syn-One Test in patients with mild cognitive impairment (MCI), and the Syn-Sleep Study, the focus of this article, will study the Syn-One Test in patients with rapid eye movement (REM) sleep behavior disorder (RBD).

RBD is a condition that causes people to act out their dreams, often with violent movements and vocalizations. Individuals with RBD may kick, punch, jump out of bed, yell, and laugh in their sleep, sometimes causing distress to their sleeping partner, and in severe cases, resulting in injuries. It is estimated that 1% of the general population and 2% of older adults have RBD2. Studies have estimated that 75%-90% of patients with RBD may go on to develop Parkinson’s disease, multiple system atrophy, or Lewy body dementia.

Recognizing the unique status of RBD as a distinct prodromal condition and early risk factor of Parkinson’s disease, The Michael J. Fox Foundation for Parkinson’s Research (MJFF) has created educational resources to help raise awareness for research opportunities for people living with RBD, which may pave the way for earlier treatment and perhaps prevention. To help shed light on RBD’s connection to Parkinson’s, MJFF launched an animation video — “What’s the Connection between Sleep and Brain Disease?” — narrated by comedian, actor and best-selling author Mike Birbiglia.

Revealing his own RBD journey on and off-stage, Birbiglia illustrates the important role people can play in helping scientists better diagnose, treat and potentially prevent brain disease. In his book Sleepwalk With Me: And Other Painfully True Stories, he recounts one particularly terrifying incident that led to his eventual diagnosis: “I fall asleep, and I have a dream that there is a guided missile headed towards my room, and there are all these military personnel in the room, and I jump out of bed, and I say: What’s the plan? And they say the missile coordinates are set specifically on you. And I decided in my dream and, as it turns out, in my life to jump out my window… So, I jumped through the window, fell two stories, landed on the front lawn of the hotel, got up and kept running3.”

As noted in a recent paper, skin biopsy techniques that utilize immunofluorescence like the Syn-One Test may identify phosphorylated alpha-synuclein in up to 89% of idiopathic RBD cases, with greater accuracy than seed amplification assays of skin or cerebrospinal fluid (CSF) 4. CND Life Sciences has received NIH funding to study the presence of phosphorylated alpha-synuclein in skin biopsies of patients with RBD. The goal of the Syn-Sleep Study is to predict when RBD is going to convert to another synucleinopathy using the Syn-One Test. Eligible participants must be between the ages of 18-85 with a history of acting out their dreams or repeated episodes of sleep-related complex motor behaviors. Additional information including contact information for study sites, can be found here.


1Gibbons CH, Levine T, Adler C, et al. Skin biopsy detection of phosphorylated α-synuclein in patients with synucleinopathies. JAMA. Published online March 20, 2024. doi:10.1001/jama.2024.0792
2 Berg D, Postuma RB, Adler CH, et al. MDS research criteria for prodromal Parkinson’s disease. Mov Disord. 2015;30(12):1600-1611. doi:10.1002/mds.26431
3 Birbiglia M. Sleepwalk With Me: And Other Painfully True Stories. Simon & Schuster; 2010.
4 Liguori R, Donadio V, Wang Z, et al. A comparative blind study between skin biopsy and seed amplification assay to disclose pathological α-synuclein in RBD. NPJ Parkinsons Dis. 2023;9(1):34. doi:10.1038/s41531-023-00473-5