Revista Brasileira de Saúde · Oct 23, 2026
REM sleep behavior disorder as an early and prognostic marker of neurodegenerative diseases: an integrative literature review
By Silva JPP, Del Vecchio CA, Lima RFDS
ARTICLE 1 REM sleep behavior disorder as an early and prognostic marker of neurodegenerative diseases: an integrative literature review 2ABSTRACT: OBJECTIVE: To study the role of REM sleep behavior disorder as an early and prognostic sign for the development and progression of neurodegenerative diseases. METHODS: An integrative review was conducted in the PubMed, Cochrane Library, and BVS/LILACS databases. The search strategy was structured using the DeCS/MeSH descriptors: "REM Sleep Behavior Disorder", "REM Sleep Behavior Disorders", "Neurodegenerative Diseases", "Parkinson Disease", "Lewy Body Disease", "Multiple System Atrophy", "Prognosis", "Biomarkers", and "Early Diagnosis", combined using the Boolean operators "AND" and "OR". Original articles, observational studies, cohort studies, longitudinal studies, and experimental studies published between 2021 and 2026, available in full text, written in English, and addressing REM sleep behavior disorder related to neurodegenerative diseases, with a focus on biomarkers, early diagnosis, and prognosis, were included. Review articles, case reports or case series, editorials, letters to the editor, conference abstracts, duplicate studies, articles without available full text, and those not directly related to the topic were excluded. RESULTS: The studies analyzed presented relevant results regarding the prognostic value of TCSREM in the early identification of α-synucleinopathies. In addition, molecular, inflammatory, neuroimaging, neurophysiological, autonomic, olfactory, and retinal biomarkers showed potential for identifying neurodegenerative changes while still in the premotor phase. These findings reinforce the potential of TCSREM and its associated biomarkers for early identification, risk stratification, and monitoring the progression of α-synucleinopathies. CONCLUSIONS: