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Isolated REM sleep behavior disorder (iRBD), a condition characterized by strong physical reactions to vivid, often violent dreams, is one of the earliest warning signs of brain changes seen in Parkinson's disease or dementia with Lewy bodies, sometimes appearing years before diagnosis.
In a new study led by Fosco Bernasconi and published in npj Parkinson's Disease, researchers explored brain responses to the heartbeat, known as heartbeat-evoked potential (HEP), and how they differ between patients with iRBD and healthy individuals.
Using overnight recordings of brain activity and heartbeat in 13 patients with iRBD and 23 healthy individuals, they showed that patients with iRBD exhibit altered HEP while awake, and these alterations tend to be more pronounced the longer an individual has had RBD symptoms.
In both patients and healthy individuals, the team also found that HEP is weaker during sleep than during wakefulness and that heart rate itself changes across different sleep stages.
Taken together, these findings show that the brain's responses to the heart change in iRBD, and these changes grow stronger with symptom duration, underscoring the potential of HEP as a biomarker for the disorder.
Fosco Bernasconi et al, Altered heart-brain coupling in awake patients with isolated REM sleep behaviour disorder, npj Parkinson's Disease (2026). DOI: 10.1038/s41531-026-01485-7
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