Abstract

Motivation: Rapid eye movement sleep behavior disorder (RBD) significantly impacts clinical outcomes in Parkinson's disease (PD). Goal(s): Our goal was to investigates the neurophysiological mechanisms related to motor and cognitive decline longitudinally in PD with RBD (PD-RBD). Approach: We used diffusion tensor imaging and clinical assessments on 83 PD patients over 2 years, two groups were formed: PD-RBD and PD without RBD (PD-nonRBD). Results: PD-RBD experienced widespread decline in white matter microstructure which are associated with motor symptoms aggravation, while PD-nonRBD patients showed limited changes. Impact: The presence of RBD suggests more extensive white matter degeneration in PD, particularly affecting motor symptoms.