NAPS2 Polysomnogram Core

ABSTRACT: NAPS2 POLYSOMNOGRAM (PSG) CORE Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior, and its neurophysiologic signature during polysomnography (PSG) is REM sleep without atonia (RSWA). RBD usually represents a prodromal synucleinopathy, and increasing evidence suggests RSWA may serve as a biomarker of synucleinopathy-related pathology: RSWA increases over time, predicts phenoconversion to overt synucleinopathy, and correlates with clinical measures of synuclein pathology. However, due to lack of data from prospective, multi-center studies, there are no established RSWA values that can be used as a biomarker. The North American Prodromal Synucleinopathy (NAPS) Consortium for RBD was established in 2018 to enable multicenter research in RBD with the long-term goal of promoting development of neuroprotective clinical trials in RBD. We successfully collected retrospective PSG data from across 10 NAPS Sites. These preliminary data demonstrate feasibility of analyzing RSWA and other neurophysiologic signals acquired during PSG across multiple sites and platforms. In NAPS Stage 2, or NAPS2, we will build on our current large cohort of participants with RBD, and will collect research-grade PSG data from >300 RBD participants twice, two years apart, and once from matched Control participants. The NAPS2 PSG Core will oversee collection, analysis, and distribution of PSG data, with the overall goal of developing RSWA as a biomarker for synucleinopathies for application in future clinical trials. The NAPS2 PSG Core will standardize and harmonize PSG data collection across NAPS2 Sites. The PSG Core will quantify REM sleep without atonia (RSWA) using a variety of methods, and determine the degree of within-individual progression in RSWA over time. The PSG Core will provide key RSWA metrics to the NAPS2 Project for assessment of RSWA as a biomarker to predict phenoconversion and track progression of synuclein-related pathology. All PSG data will be shared publicly through the NIH-sponsored National Sleep Research Resource (NSRR), a national repository of sleep-based electrophysiologic data. We will coordinate with the NAPS2 Data Management and Statistical (DMS) Core to develop signal processing and novel machine learning methods for application to electroencephalography and other neurophysiological signals recorded during PSG. The PSG Core will explore the feasibility and reliability of alternative, non-laboratory methods for home-based PSG. The NAPS2 PSG Core will enable development of RSWA as a biomarker for prodromal synucleinopathies, promote research with PSG-derived neurophysiologic signals, and advance technological improvements in PSG data collection and analysis.