Latest news with #RBD
Business Recorder
10-07-2025
- Business
- Business Recorder
Malaysian palm oil futures extend gains on stronger Dalian oils
JAKARTA: Malaysian palm oil futures rose for a third straight session to its highest in nearly three months on Wednesday, supported by gains in rival Dalian oils and a weaker ringgit, but weak Chicago soyoil limits gain. The benchmark palm oil contract for September delivery on the Bursa Malaysia Derivatives Exchange climbed 0.27% to 4,159 ringgit ($979.05) a ton at closing. Palm was supported by good gains in Dalian's RBD palm olein and a continued depreciation of the local currency, said a Kuala Lumpur-based trader. Dalian's most-active soyoil contract gained 0.15%, while its palm oil contract climbed 1.45%. Soyoil prices on the Chicago Board of Trade were down 0.74% Palm oil tracks price movements of rival edible oils, as it competes for a share of the global vegetable oils market.
Business Recorder
09-07-2025
- Business
- Business Recorder
Palm extends gains on stronger Dalian oils, weaker ringgit
JAKARTA: Malaysian palm oil futures rose for a third straight session on Wednesday, supported by gains in rival Dalian oils and a weaker ringgit. The benchmark palm oil contract for September delivery on the Bursa Malaysia Derivatives Exchange climbed 0.43% to 4,166 ringgit ($980.00) by the midday break. It had gained 2.12% in the previous two sessions. Palm was supported by good gains in Dalian's RBD palm olein and a continued depreciation of the local currency, said a Kuala Lumpur-based trader. Dalian's most-active soyoil contract gained 0.30%, while its palm oil contract climbed 1.52%. Soyoil prices on the Chicago Board of Trade slid 0.54% Palm oil tracks price movements of rival edible oils, as it competes for a share of the global vegetable oils market. The ringgit, palm's currency of trade, weakened 0.33% against the dollar, making the commodity cheaper for buyers holding foreign currencies. Palm oil may test resistance at 4,195 ringgit per ton, a break above which could lead to a gain into the 4,219 ringgit to 4,233 ringgit range, Reuters technical analyst Wang Tao said. Meanwhile, an Indonesian palm oil group said on Tuesday the country's exports to the United States may fall due to the 32% tariffs threatened on Indonesian goods, allowing competitors in Malaysia to gain market share as they face lower tariffs.
Los Angeles Times
12-06-2025
- Health
- Los Angeles Times
Why REM Sleep Behavior Disorder Is a Warning Sign for Parkinson's and Other Brain Diseases
REM Sleep Behavior Disorder (RBD) might sound like something out of a sleepwalker's nightmare, but it's a very real—and increasingly important—sleep disorder. RBD occurs when the normal muscle paralysis, known as muscle atonia, during REM (rapid eye movement) sleep disappears, allowing individuals to physically act out their dreams during dream sleep. REM sleep is one of several sleep stages, also referred to as paradoxical sleep or active sleep, and is characterized by rapid eye movements and vivid dreaming. This loss of muscle atonia can involve anything from flailing limbs to more aggressive or even violent behaviors, potentially resulting in injury to the sleeper or their bed partner. Once seen as a rare curiosity, RBD is now recognized as both a disruptive parasomnia and a warning sign of more serious neurological conditions—especially neurodegenerative disorders known as synucleinopathies, such as Parkinson's disease, Lewy body dementia, and multiple system atrophy (MSA). This dual significance places RBD at a unique crossroads between sleep medicine and neurology. Pinpointing RBD isn't just about noticing odd behavior at night. While many patients (or more often, their partners) report vivid, sometimes violent dream enactment, true diagnosis requires polysomnography—an overnight sleep study that records brain activity, muscle tone, and eye movements. RBD diagnosis relies on identifying abnormal behaviors during the REM stage of the sleep cycle. Specifically, clinicians look at the REM stage as a specific sleep stage for the presence or absence of muscle atonia—REM sleep without atonia indicates a loss of the muscle paralysis that should naturally occur during this phase. According to a 2017 review in Mayo Clinic Proceedings [1], this diagnostic confirmation is vital—not just to guide treatment, but also to identify those at heightened risk for developing a neurodegenerative disorder. And that risk is real. A 2025 study titled The Many Faces of REM Sleep Behavior Disorder [4] found that individuals with idiopathic RBD (i.e., RBD not linked to medications or other causes) have a significant chance of developing Parkinson's or DLB within a decade. This makes RBD one of the most robust prodromal biomarkers in neurology today. First and foremost, in managing RBD, we need to keep patients and partners safe. That often means adapting the sleep environment—removing sharp objects, padding furniture, or even sleeping separately if necessary. RBD often coexists with other sleep disorders which can complicate management and require a comprehensive approach. But pharmacological treatment can also be very effective. Two drugs are front runners: The 2025 International RBD Study Group consensus [2] also explores new territory, finding potential benefit from cholinesterase inhibitors like rivastigmine and dopamine agonists such as pramipexole. However, these are still under investigation and treatment must be individualized based on symptom severity, age and co-existing conditions. Good sleep hygiene and lifestyle modifications are also important. Avoiding sleep deprivation and ensuring a sufficient sleep period helps promote enough sleep and enough REM sleep which are critical for overall health and RBD management. Perhaps the most exciting—and urgent—aspect of RBD is its predictive value. Multiple studies show RBD isn't just a symptom; it may be an early sign that the brain is already undergoing neurodegenerative changes long before other signs appear. REM sleep plays a crucial role in brain development and maintaining the brain's ability to process information and regulate emotions, making its disruption particularly important in the context of RBD. Advanced neuroimaging and cerebrospinal fluid biomarkers have shown early pathology in many patients with idiopathic RBD. This aligns with broader research on alpha-synuclein accumulation in the brain—key in Parkinson's and DLB development [5]. A 2020 review in Frontiers in Neurology [3] reminds us we need to watch for neurologic signs. Ongoing brain research and sleep research will continue to uncover why REM sleep is important for early detection of neurodegenerative changes. That means screening not only for motor symptoms but for early cognitive changes—because acting out dreams today could mean dementia tomorrow. New studies are looking at what might contribute to or worsen RBD risk and severity. These are early days but here are some findings: A full night's sleep typically has four or five cycles of alternating REM and NREM sleep (also called non REM sleep). Each sleep cycle has light sleep, deep sleep and REM (also called paradoxical sleep or desynchronized sleep). During the deep sleep stage of NREM, breathing slows, blood pressure drops and the immune system is boosted. REM sleep (also called active sleep, dream sleep or rapid eye movement REM) is characterized by rapid eye movements, vivid dreaming and variable brain waves. Most people experience REM sleep several times a night. Sleep cycles repeat throughout the night and after each cycle a new sleep cycle begins. Adults need seven to nine hours of sleep to complete enough cycles for optimal health. Sleep deprivation or a shortened sleep period can reduce enough REM sleep and deep sleep leading to negative health sleep apnea and other sleep disorders can disrupt sleep architecture reducing sleep time and quality of both REM and NREM sleep. Daytime naps can supplement nighttime sleep and help those who haven't slept enough at night. Sleep medicine reviews and sleep research have shown the importance of maintaining healthy sleep cycles for the brain to function and overall well-being. These findings support a holistic approach to RBD care—one that considers sleep hygiene, lifestyle and even dietary factors as part of the treatment. REM Sleep Behavior Disorder is no longer just a sleep curiosity—it's a diagnostic warning sign that may sound years before neurodegenerative disease sets in. While traditional treatments like clonazepam and melatonin work for symptom control, newer research points to the possibility of disease interception. As we learn more about sleep, neurobiology and behavior, RBD may become a key entry point for early intervention in Parkinson's, DLB and related conditions. The future of sleep medicine will shape the future of neurology—and for those with RBD that's good news. [1] St Louis, E. K., & Boeve, B. F. (2017). REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions. Mayo Clinic proceedings, 92(11), 1723–1736. [2] During, E. H., Malkani, R., Arnulf, I., Kunz, D., Bes, F., De Cock, V. C., Ratti, P. L., Stefani, A., Schiess, M. C., Provini, F., Schenck, C. H., & Videnovic, A. (2025). Symptomatic treatment of REM sleep behavior disorder (RBD): A consensus from the international RBD study group - Treatment and trials working group. Sleep medicine, 132, 106554. [3] Roguski, A., Rayment, D., Whone, A. L., Jones, M. W., & Rolinski, M. (2020). A Neurologist's Guide to REM Sleep Behavior Disorder. Frontiers in neurology, 11, 610. [4] Arnaldi, D., Mattioli, P., Orso, B., Massa, F., Pardini, M., Morbelli, S., Nobili, F., Figorilli, M., Casaglia, E., Mulas, M., Terzaghi, M., Capriglia, E., Malomo, G., Solbiati, M., Antelmi, E., Pizza, F., Biscarini, F., Puligheddu, M., & Plazzi, G. (2025). The Many Faces of REM Sleep Behavior Disorder. Providing Evidence for a New Lexicon. European journal of neurology, 32(4), e70169. [5] Hu M. T. (2020). REM sleep behavior disorder (RBD). Neurobiology of disease, 143, 104996. [6] Coelho, J., Samalin, L., Yrondi, A., Iftimovici, A., Philip, P., & Micoulaud-Franchi, J. A. (2025). La santé du sommeil comme marqueur et cible d'intervention dans les troubles psychiatriques [Sleep health as a marker and target for health interventions in psychiatric disorders]. Medicine sciences : M/S, 41(5), 477–489. [7] Wang, P., Chen, X., Na, M., Flores-Torres, M. H., Bjornevik, K., Zhang, X., Chen, X., Khandpur, N., Rossato, S. L., Zhang, F. F., Ascherio, A., & Gao, X. (2025). Long-Term Consumption of Ultraprocessed Foods and Prodromal Features of Parkinson Disease. Neurology, 104(11), e213562. [8] Mondino, A., Jadidian, A., Toth, B. A., Hambrecht-Wiedbusch, V. S., Floran-Garduno, L., Li, D., York, A. K., Torterolo, P., Pal, D., Burgess, C. R., Mashour, G. A., & Vanini, G. (2025). Regulation of REM and NREM Sleep by Preoptic Glutamatergic Neurons. Sleep, zsaf141. Advance online publication.
Medscape
10-06-2025
- Health
- Medscape
Forget the Tremor: These Symptoms Come First in Parkinson's
Patients with Parkinson's disease rarely present to the clinic with the textbook signs — forward stooped posture, slow and rigid movements, or shuffling gait. Instead, the earliest indicators are often vague and nonspecific, though they can later be recognized as early warning signs in retrospect. By the time the first clear symptoms appear, nearly 50% of dopaminergic neurons are irreversibly lost. The resulting dopamine deficiency disrupts the motor system, leading to hallmark symptoms such as tremor, rigidity, akinesia, and postural instability (TRAP). Diagnosis is clinical, supported by characteristic signs, and often confirmed with imaging (eg, dopamine transporter scan [DaT SCAN]). Onset is usually gradual and progressive, and symptoms may present asymmetrically. Although Parkinson's disease remains incurable, identifying these early signs before the onset of classic motor symptoms can enable timely monitoring and potential early intervention. The earlier the disease is detected, the better its progression may be slowed. Some symptoms may manifest years in advance. Below is an overview of early and prodromal Parkinson's symptoms. While most clinicians routinely ask about sleep or gastrointestinal function, the following list may help prompt more targeted follow-up when suspicion arises. Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD) Sleep disturbances are often mentioned as early Parkinson's symptoms, but the specific disorder — REM sleep behavior disorder — is frequently overlooked. Unlike insomnia or sleep maintenance issues, RBD involves vivid dreaming accompanied by physical movements, such as shouting, punching, or kicking during sleep, often affecting the sleep partner. RBD occurs in about 0.5%-1% of the population, rising to 5% in those older than 60 years. Importantly, it is considered a prodromal condition for Parkinson's: 80% of those affected may go on to develop the disease within 15 years. Patients reporting these symptoms should be monitored regularly for neurologic changes. In clinical history-taking, ask specifically about vivid dreams, violent movements during sleep, or vocalizations. Though often dismissed as quirky or anecdotal, recurring incidents should raise red flags. Constipation Parkinson's doesn't begin with tremors or slowed movement. Nonmotor symptoms, especially gastrointestinal issues, often appear first. The disease affects the autonomic nervous system, including the enteric nervous system that regulates bowel motility. There is evidence that pathological changes — such as alpha-synuclein accumulation — begin in the gut and olfactory bulb before affecting the brain, aligning with the Braak hypothesis. These protein aggregates can cause constipation or olfactory dysfunction long before motor symptoms emerge. Studies suggest chronic constipation can precede a Parkinson's diagnosis by 10-20 years. Up to 75% of patients with Parkinson's experience it. While constipation alone is nonspecific, it gains significance when combined with other prodromal signs. Constipation should raise concern in these contexts: Persistent, unexplained symptoms. Co-occurrence with other early signs such as: Loss of smell (hyposmia). REM sleep behavior disorder. Depressed mood. Fatigue or lack of motivation. Family history of Parkinson's. Olfactory Dysfunction Loss of smell, either partial (hyposmia) or total (anosmia), is another early and often unnoticed sign. Patients may have difficulty detecting even strong odors like coffee, bananas, or pickles. In Parkinson's, misfolded alpha-synuclein protein aggregates disrupt brain regions, including those responsible for olfaction. These changes may impair neuron function and contribute to early sensory loss. Animal studies suggest alpha-synuclein may behave like a prion — spreading through neural pathways. Trials are ongoing to determine whether monoclonal antibodies such as prasinezumab could help degrade these protein aggregates. Micrographia As Parkinson's disrupts dopamine pathways, it impairs fine motor control. Writing — a highly complex motor task — often becomes affected. Reduced movement amplitude can lead to smaller, cramped handwriting known as micrographia. Micrographia is a typical, though not universal, early motor sign and may precede other motor symptoms. It often appears alongside other signs like a softer, monotone voice or reduced arm swing while walking — both early signs of extrapyramidal dysfunction. Classic Motor Signs: TRAP Parkinson's is commonly associated with: Tremor : A resting tremor, typically 4-8 Hz, which diminishes with movement (unlike intention tremor). : A resting tremor, typically 4-8 Hz, which diminishes with movement (unlike intention tremor). Rigidity : Muscle stiffness is often described as 'cogwheel rigidity' due to a ratcheting resistance during passive limb extension. : Muscle stiffness is often described as 'cogwheel rigidity' due to a ratcheting resistance during passive limb extension. Akinesia/bradykinesia : Slowness or poverty of movement, including 'freezing' episodes that require verbal cues to initiate or stop movement. : Slowness or poverty of movement, including 'freezing' episodes that require verbal cues to initiate or stop movement. Postural instability: Impaired balance and increased risk of falls, not due to cerebellar, visual, or vestibular dysfunction. Postural instability is now recognized as a cardinal sign in the TRAP framework. Damage to extrapyramidal reflexes means patients may be unable to catch themselves when off balance. Additional Early Signs Depression and anxiety : Often overlooked or misdiagnosed as primary psychiatric conditions. : Often overlooked or misdiagnosed as primary psychiatric conditions. Reduced facial expression (hypomimia) : 'Masked' appearance due to reduced facial muscle movement. : 'Masked' appearance due to reduced facial muscle movement. Diffuse pain : Especially in the shoulders, back, or arms, sometimes preceding motor signs. : Especially in the shoulders, back, or arms, sometimes preceding motor signs. Fatigue : Persistent lack of energy not relieved by rest. : Persistent lack of energy not relieved by rest. Reduced arm swing: Subtle early sign of movement asymmetry. When to Refer for Neurological Evaluation None of these symptoms alone confirm Parkinson's disease, as many are nonspecific or seen in other conditions. However, the presence of multiple early signs — especially the combination of REM sleep behavior disorder, olfactory loss, constipation, or family history — should prompt further evaluation. Referral should ideally be made to a neurologist specializing in movement disorders. A thorough neurologic exam, smell testing, sleep studies (polysomnography), and imaging (eg, DaT SCAN) may be warranted. Summary Table. Common Early and Prodromal Parkinson's Symptoms Symptom Description Frequency Lead Time Before Diagnosis Olfactory dysfunction (hyposmia) Reduced sense of smell; often the first sign, typically unnoticed Very common 5-15 years RBD Acting out dreams (eg, shouting, punching, or kicking) Common 10-15 years Depression, anxiety Mood disturbance, social withdrawal, loss of interest Common 5-10 years Constipation Reduced bowel motility; often chronic Common 10-20 years Pain (shoulders, back, or limbs) Diffuse musculoskeletal pain Common Can occur early Fatigue Chronic low energy not improved by sleep Moderate-common Years before diagnosis TRAP Classic cardinal signs (TRAP), often asymmetric at onset Very common Early symptom Micrographia Small, cramped handwriting Common Early symptom Hypomimia Mask-like facial expression Common Early symptom Reduced arm swing Asymmetry in arm movement while walking Common Early symptom RBD = rapid eye movement sleep behavior disorder; TRAP = tremor, rigidity, akinesia, and postural instability Identifying these signs early and recognizing meaningful combinations — not isolated symptoms — can help clinicians initiate earlier referral and intervention, potentially altering the disease trajectory.
NDTV
30-05-2025
- Health
- NDTV
Sleeping Disorders May Signal Risk Of Parkinson's Disease, Dementia: Study
New Delhi: Sleeping disorders may act as an early indicator of neurodegenerative diseases like Parkinson's disease and Lewy body dementia (LBD) -- a type of dementia, according to a study. The study focused on patients with Rapid eye movement behaviour disorder -- a sleep disorder where individuals physically act out their dreams during the rapid eye movement (REM) stage of sleep. "Normally, when we're asleep and dreaming, our muscles are paralysed, but around age 50, some people become very agitated during sleep and start punching, kicking and screaming," said Shady Rahayel, a medical professor at Université de Montréal in Canada. Unlike sleepwalking, which occurs during slow-wave sleep, RBD occurs during rapid eye movement (REM) sleep, he added, and it affects people of middle age. In the study, published in the journal eBioMedicine, the researchers said that nearly 90 per cent of people with the disorder will go on to develop either Parkinson's disease or LBD. "RBD is an early warning sign that certain mechanisms in the brain are no longer working as they should," said the team. "The people with RBD who come to see us are in good health... but of those who subsequently develop a disease, half will have Parkinson's and the other half LBD." Rahayel explained that with LBD, the second most common form of dementia after Alzheimer's, "patients are no longer able to function in everyday life". In addition to dementia, "they will have Parkinson's-like symptoms, vivid visual hallucinations, fluctuating attention and other symptoms." For the study, the team used data from 1,276 MRI scans of people at risk of, or with, Parkinson's disease or LBD, and also of healthy people. Using machine learning and computational models, the researchers identified two trajectories of brain atrophy progression. LBD seems to be associated with brain atrophy that begins in the cortex and then spreads to the interior of the brain, while in Parkinson's the atrophy progresses from the interior to the exterior of the brain. The team next aims to investigate the factors that lead to this deterioration in the cortex, such as vascular lesions, the effects of drugs, and of lifestyle choices. "Now that we have identified these new progression patterns, our goal is to be able to determine from an MRI whether a person has one of them so that we can provide the best possible care," said Rahayel.
