Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with rapid eye movement sleep behavior disorder: a substudy of the North American Prodromal Synucleinopathy Consortium.

STUDY OBJECTIVES: Rapid eye movement sleep behavior disorder (RBD) is strongly associated with phenoconversion to an overt synucleinopathy, e.g. Parkinson's disease (PD), Lewy body dementia, and related disorders. Comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)-henceforth "neurotrauma" (NT)-increase the odds of RBD by ~2.5-fold and are associated with an increased rate of service-connected PD in Veterans. Thus, RBD and NT are both independently associated with PD; however, it is unclear how NT influences neurological function in patients with RBD. METHODS: Participants ≥18 years with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 through the North American Prodromal Synucleinopathy Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory, and autonomic function, were completed. This cross-sectional analysis compared cases (n = 24; RBD + NT) to controls (n = 96; RBD), matched for age (~60 years), sex (15% female), and years of education (~15 years). RESULTS: RBD + NT reported earlier RBD symptom onset (37.5 ±â€…11.9 vs. 52.2 ±â€…15.1 years of age) and a more severe RBD phenotype. Similarly, RBD + NT reported more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to RBD. No differences in olfaction or color vision were observed. CONCLUSIONS: This cross-sectional, matched case:control study shows individuals with RBD + NT have significantly worse neurological measures related to common features of an overt synucleinopathy. Confirmatory longitudinal studies are ongoing; however, these results suggest RBD + NT may be associated with more advanced neurological symptoms related to an evolving neurodegenerative process.

Optimization approaches to ameliorate humidity and vibration related issues using the microAeth black carbon monitor for personal exposure measurement.

Exposure to ambient black carbon (BC) is associated with adverse health effects. Black carbon levels display large spatial and temporal variability in many settings, such as cities and rural households where fossil fuel and biomass, respectively, are commonly burned for transportation, heat and cooking. This paper addresses the optimization of the miniaturized personal BC monitor, the microAeth® for use in epidemiology studies. To address false positive and negative peaks in real time BC concentrations resulting from changes in temperature and humidity, an inlet with a diffusion drier was developed. In addition, we developed data cleaning algorithms to address occasional false positive and negative fluctuations in BC readings related to physical vibration, due in part to both dirt accumulations in the optical inserts and degraded components. These methods were successfully used to process real-time BC data generated from a cohort of 9-10 year old children (N= 54) in NYC, who wore 1 or 2 microAeth units for six 24hr time periods. Two hour and daily BC averages after data cleaning were consistent with averaged raw data (slopes near 1 with R =0.99, p<0.001; R= 0.95, p<0.001, respectively), strongly suggesting that the false positive and negative excursions balance each other out when averaged for at least 2 hrs. Data cleaning of identified suspect events allows more confidence in the interpretation of the real-time personal monitoring data generated in environmental exposure studies, with mean percent difference <10% for 19 duplicate deployments.