The Portland SEEQ: A Harmonizable Questionnaire for Environmental Exposome Profiling in Prodromal Synucleinopathy

In polysomnography-confirmed isolated REM sleep behavior disorder, the Portland Suspected Environmental Exposures Questionnaire showed high completion (81/83, 97.6%) and quantified definite/probable exposures.

• Why it matters: Existing tools inconsistently capture specific agents, co-exposures, exposure uncertainty, timing, and mitigating factors, limiting environmental exposome profiling in prodromal synucleinopathy.
• What they did: SEEQ was iteratively developed to assess pesticides, solvents/industrial chemicals, welding fumes, heavy metals, and lifestyle factors, classifying direct exposures as definite/probable/possible/uncertain and collecting frequency, life stage, and protective-equipment use.
• The result: Definite/probable exposure prevalence was 38.6% for pesticides, 43.4% for solvents/industrial chemicals, 21.0% for welding fumes, and 34.1% for heavy metals; exposure burden was cross-sectionally linked to greater autonomic symptom burden but not longitudinal clinical worsening.