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Serum Ferritin and Inflammation in Isolated REM Sleep Behavior Disorder: A Longitudinal Study
Weifang Yin1, Xinyan Zhang1, Jiafeng Ren1
1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Neurology
|August 4, 2026
Summary
Elevated serum ferritin in isolated REM sleep behavior disorder (iRBD) is linked to worse symptoms and increased neurodegeneration risk. This suggests iron metabolism dysregulation may drive iRBD progression and inflammation.
Area of Science:
- Neuroscience
- Sleep Medicine
- Biochemistry
Background:
- Isolated REM sleep behavior disorder (iRBD) is a prodromal stage for α-synucleinopathies.
- Iron metabolism and inflammation are implicated in neurodegenerative disease pathogenesis.
Purpose of the Study:
- Investigate peripheral iron metabolism and inflammation in iRBD patients.
- Analyze associations with clinical features and disease progression.
Main Methods:
- Prospective observational cohort study of 113 iRBD patients and 99 healthy controls.
- Measured iron metabolism markers, inflammatory markers (CRP, IL-6, IL-10, TNF-α).
- Used Cox regression to assess neurodegenerative disease risk.
Main Results:
- iRBD patients showed dysregulated iron metabolism with elevated serum ferritin.
- Higher ferritin correlated with RBD severity, autonomic dysfunction, and REM sleep without atonia.
- Elevated ferritin predicted increased risk of phenoconversion to neurodegenerative diseases (HR 2.91).
- High ferritin associated with increased IL-10 and TNF-α levels, and correlated with CRP and TNF-α.
Conclusions:
- Peripheral iron metabolism is dysregulated in iRBD.
- Elevated serum ferritin indicates a more severe prodromal neurodegenerative phenotype.
- Peripheral iron metabolism may correlate with inflammation in iRBD neurodegeneration.
