The Portland SEEQ: A Harmonizable Questionnaire for Environmental Exposome Profiling in Prodromal Synucleinopathy
- 1University of Iowa
Abstract
Objective: To describe development of the Portland Suspected Environmental Exposures Questionnaire (SEEQ) and its initial application for environmental exposome profiling in isolated REM sleep behavior disorder (iRBD). Background: Environmental exposures may contribute to Parkinson disease and related synucleinopathies, yet existing instruments variably capture specific agents, co-exposures, exposure uncertainty, timing, and mitigating factors. Methods: SEEQ was iteratively developed to assess pesticides, solvents/industrial chemicals, welding fumes, heavy metals, residential and occupational exposures, and relevant lifestyle factors. Direct exposures were classified as definite, probable, possible, or uncertain/unlikely, with additional assessment of frequency/duration, life stage, and protective-equipment use. SEEQ was administered to participants with polysomnography-confirmed iRBD. Exposure prevalence, co-exposure patterns, and exploratory associations with clinical phenotypes and longitudinal progression were examined. Results: Eighty-three participants completed SEEQ; 81 (97.6%) completed all four direct exposure domains. Definite/probable exposure was reported for pesticides in 38.6%, solvents/industrial chemicals in 43.4%, welding fumes in 21.0%, and heavy metals in 34.1%. Among complete responders, 60.5% reported [≥]1 and 42.0% [≥]2 direct exposure domains. Forty-five participants identified [≥]1 named agent or mixture. Greater exposure burden was cross-sectionally associated most consistently with greater autonomic symptom burden, but was not associated with longitudinal clinical worsening. Conclusion: SEEQ provides a practical, multidomain framework for structured environmental exposome profiling in prodromal synucleinopathy. Larger studies with external exposure validation and longitudinal follow-up are needed.
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BibTeX
@misc{neilson2026portland,
title = {{The Portland SEEQ: A Harmonizable Questionnaire for Environmental Exposome Profiling in Prodromal Synucleinopathy}},
author = {L. Neilson and H. Cunningham and J. Locke and J. E. Elliott and M. M. Lim},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.26.26366216},
url = {https://www.medrxiv.org/content/10.64898/2026.10.26.26366216v1},
note = {CC0},
}
RIS
TY - UNPB
TI - The Portland SEEQ: A Harmonizable Questionnaire for Environmental Exposome Profiling in Prodromal Synucleinopathy
AU - L. Neilson
AU - H. Cunningham
AU - J. Locke
AU - J. E. Elliott
AU - M. M. Lim
PY - 2026
DA - 2026/10/26
PB - medRxiv
DO - 10.64898/2026.10.26.26366216
UR - https://www.medrxiv.org/content/10.64898/2026.10.26.26366216v1
AB - Objective: To describe development of the Portland Suspected Environmental Exposures Questionnaire (SEEQ) and its initial application for environmental exposome profiling in isolated REM sleep behavior disorder (iRBD). Background: Environmental exposures may contribute to Parkinson disease and related synucleinopathies, yet existing instruments variably capture specific agents, co-exposures, exposure uncertainty, timing, and mitigating factors. Methods: SEEQ was iteratively developed to assess pesticides, solvents/industrial chemicals, welding fumes, heavy metals, residential and occupational exposures, and relevant lifestyle factors. Direct exposures were classified as definite, probable, possible, or uncertain/unlikely, with additional assessment of frequency/duration, life stage, and protective-equipment use. SEEQ was administered to participants with polysomnography-confirmed iRBD. Exposure prevalence, co-exposure patterns, and exploratory associations with clinical phenotypes and longitudinal progression were examined. Results: Eighty-three participants completed SEEQ; 81 (97.6%) completed all four direct exposure domains. Definite/probable exposure was reported for pesticides in 38.6%, solvents/industrial chemicals in 43.4%, welding fumes in 21.0%, and heavy metals in 34.1%. Among complete responders, 60.5% reported [≥]1 and 42.0% [≥]2 direct exposure domains. Forty-five participants identified [≥]1 named agent or mixture. Greater exposure burden was cross-sectionally associated most consistently with greater autonomic symptom burden, but was not associated with longitudinal clinical worsening. Conclusion: SEEQ provides a practical, multidomain framework for structured environmental exposome profiling in prodromal synucleinopathy. Larger studies with external exposure validation and longitudinal follow-up are needed.
ER -