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2 bizarre early signs of Parkinson’s disease


Symptoms such as loss of smell and acting out dreams due to REM Sleep Behavior Disorder put people at an 80% chance of developing Parkinson’s disease, or PD, within ten years.

Physicians with the Cedars-Sinai Movement Disorders Program explained these strange predictive symptoms at a recent Parkinson’s disease community event at the hospital’s Harvey Morse Conference Center in Los Angeles. PD is treated with deep brain stimulation and certain medications that mitigate the disease’s depletion of dopamine, a chemical messenger that contacts parts of the brain tasked with movement. At this time, there is no complete cure.

Few people who develop PD have genetic mutations, but both the loss of smell, known as hyposmia, and acting out during REM sleep are widely acknowledged to be accurate predictors for the disease. The Michael J. Fox Foundation for Parkinson’s Research is another organization seeking to better understand the relationship between smell loss, REM Sleep Behavior Disorder, and the onset of PD, which is typically caused by aging and environmental factors.


According to the MJFF, “Early detection is a crucial step to understanding the causes of and developing better treatments for Parkinson’s disease. Even before the typical tremor and slowness of movements occur in PD, it may be possible to detect early changes in the brain and symptoms that are associated with PD. Loss of sense of smell is a common but little noticed symptom that may occur years before the onset of motor symptoms or a PD diagnosis.” Because of the strong connection, Michael J. Fox’s foundation includes hyposmia research in its flagship biomarker study of the disease.

REM Sleep Behavior Disorder causes nightmares in which patients believe they are being assaulted or chased, and respond to the dreams by screaming and thrashing about in their beds. Several studies using neuroimaging techniques have proven that the disorder is a risk factor for Parkinson’s disease. Researchers determined that dopamine levels dropped in these patients across several years, ultimately leading to a diagnosis of PD or other neurodegenerative diseases.

The goal for clinicians is to improve diagnostics and develop new therapies for PD that build upon early recognition of hyposmia and REM Sleep Behavior Disorder.

Edwin A. Boynton