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The nonmotor symptoms of Parkinson disease (PD) may manifest decades before motor symptoms appear, but currently no reliable blood biomarker can establish the prodromal phase. To investigate the potential of α-synuclein in neuronally derived serum extracellular vesicles as a prodromal marker for PD and related dementia, researchers conducted a large retrospective cross-sectional study, analyzing serum samples from the Oxford Discovery, Marburg, and Cologne cohorts and the Parkinson's Progression Markers Initiative cohort. First, they identified a derivation group including 170 participants with polysomnography-proven isolated rapid eye movement sleep behavior disorder (iRBD) and controls. L1 cell adhesion molecule–positive extracellular ves…