Neuroplasticity and the emergence of motor and cognitive deficits in prodormal synucleinopathy

Parkinson’s disease, dementia with Lewy bodies, and related synucleinopathies have a long prodromal stage, lasting years to decades, during which neurodegeneration progresses insidiously across the nervous system. Compensatory neuroplastic changes in structural and functional connectivity are thought to occur during the prodromal stage that mask the expression of motor and non-motor signs. Currently, little is known about the temporal evolution of structural and functional adaptations, the state of cortical neuroplasticity, and how these factors contribute to the masking and/or emergence of motor and cognitive signs during prodromal disease. This project will study the progression of disease in people with isolated rapid eye movement (REM) behavior sleep disorder (iRBD), a sleep disturbance characterized by elevated muscle activity during REM sleep, in conjunction with dream enactment. IRBD is recognized as a prodromal stage of synucleinopathy since more than 70% of people with this disorder eventually develop Parkinson’s disease, dementia with Lewy bodies, or multiple system atrophy. The goal of this project is to characterize the temporal evolution of neuroplastic changes in the structure and function of the brain in people with iRBD and to identify factors contributing to the masking and/or emergence of motor and cognitive signs.