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REM sleep behavior disorder (RBD) is a parasomnia characterized by a loss of atonia and an increased phasic muscle activity during REM sleep. Idiopathic RBD frequently herald an alpha-synucleinopathy, including such as Parkinson's disease (PD) and dementia with Lewy Body (DLB). Pathological changes in the anterior olfactory nucleus and olfactory loss occur very early in the course of PD and DLB. The aim of the study was to assess olfactory function in a large group of idiopathic RBD patients.

Fifty-four consecutive polysomnographically-confirmed iRBD patients (44 men, 10 women; mean age: 69.2±8.3 years; mean Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score: 4.9±4.3) and 54 age and gender-matched control subjects underwent the Brief University of Pennsylvania Smell Identification Test (B-SIT).

A marked olfactory impairment was observed …