The Ikelos-Rating Scale (Ikelos-RS) is a new, expert-interviewed and bedpartner-reported severity marker assessing frequency and expression of isolated REM sleep behaviour disorder (iRBD), a precursor of clinical α-synucleinopathies. This study aimed to validate the Ikelos-RS in 180 patients with three-night PSG-confirmed iRBD (68.4 ± 8.3 years
139 m). Inter-rater (n = 45) and test-retest reliabilities (n = 25
174 Ikelos-RS) were evaluated. For construct validity, correlation analyses were performed with: (1) Clinical Global Impressions-Severity (CGI-S
n = 151), (2) REM sleep without atonia (RWA) within videometry (n = 20), (3) RWA at initial diagnosis (n = 131) and changes over time (n = 36), (4) dopamine transporter scintigraphy (DaT-SPECT) at baseline and changes over time (n = 75). RWA- and DaT-SPECT-analyses were conducted for the whole sample ('all') and after excluding confounders ('cleaned'). Correlation analyses indicated high inter-rater (r