Season 7 | Episode 13
In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Luca Baldelli, a neurologist from the University of Bologna and Treasurer-Elect of the International REM Sleep Behavior Disorder Study Group, to discuss breakthrough research on predicting which RBD patients will develop neurodegenerative diseases.
Building on the AASM’s updated RBD guidelines, Dr. Baldelli presents compelling evidence for using simple autonomic reflex testing to identify patients at highest risk for phenoconversion to conditions like Parkinson’s disease and dementia with Lewy bodies. His research demonstrates that objective autonomic testing, particularly orthostatic assessments, can reveal early cardiovascular dysfunction that precedes overt neurodegeneration by years.
The conversation explores practical clinical applications: How can sleep medicine practitioners implement these screening protocols? What constitutes abnormal autonomic function in RBD patients? How do we interpret changes over time, and when should patients be referred for neurological evaluation? Dr. Baldelli shares his longitudinal monitoring framework that could transform how we counsel RBD patients about their future risk.
This episode addresses critical questions about biomarker development in prodromal neurodegeneration, the timeline of autonomic changes, and evidence-based approaches to patient discussions about prognosis. Dr. Baldelli also discusses current research initiatives and potential therapeutic interventions for high-risk patients.
Whether you’re a sleep medicine physician, neurologist, or researcher interested in neurodegenerative diseases, this episode provides essential insights into improving early detection and patient care in RBD.
Join us for this informative discussion that bridges sleep medicine and neurology to enhance clinical decision-making and patient outcomes.
Dr. Luca Baldelli
Dr. Luca Baldelli is a Junior Assistant Professor of Neurology from the University of Bologna, where he trained under the mentorship of Professors Pietro Cortelli and Federica Provini.
Graduating with honors in Medicine and Surgery in 2017, he soon focused his efforts on isolated REM Sleep Behavior Disorder (iRBD) as a prodromal marker of α-synucleinopathies, earning a one-year research fellowship within a Horizon 2020 project. Over the following years, his work focused on isolated REM Sleep Behavior Disorder (iRBD) as a prodromal stage of α-synucleinopathies, with particular emphasis on cardiovascular autonomic failure as a multidimensional biomarker. His recent studies have demonstrated that objective autonomic testing, especially autonomic reflex testing (ART), reveals early and progressive cardiovascular dysfunction in iRBD patients, and can predict phenoconversion to overt neurodegenerative disease, offering a valuable tool for both clinical management and trial readiness.
Dr. Baldelli completed his PhD in Biomedical and Neuromotor Sciences at the University of Bologna, where he investigated the impact of Deep Brain Stimulation on sleep and circadian regulation in Parkinson’s Disease, combining sleep assessments with chronic subthalamic local field potential recordings.
He is the author of over 35 peer-reviewed publications and has contributed to multiple national and international research initiatives in the fields of sleep medicine, autonomic neuroscience, and movement disorders. Dr. Baldelli is an active member of the international scientific community, currently serving as Treasurer Elect of the International REM Sleep Behavior Disorder Study Group (IRBDSG), as a task force member within the IRLSSG, and as an elected representative on the EAN Scientific Panel on Sleep-Wake Disorders Management Group.
His research aims to bridge clinical neurology and translational science to improve early diagnosis and biomarker-based stratification in neurodegenerative disease.
