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Antonioni A, Raho EM, Sensi M, Di Lorenzo F, Fadiga L, Koch G. A new perspective on positive symptoms: expression of damage or self-defence mechanism of the brain? Neurol Sci 2024; 45:2347-2351. [PMID: 38353846 PMCID: PMC11021333 DOI: 10.1007/s10072-024-07395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/05/2024] [Indexed: 04/17/2024]
Abstract
Usually, positive neurological symptoms are considered as the consequence of a mere, afinalistic and abnormal increase in function of specific brain areas. However, according to the Theory of Active Inference, which argues that action and perception constitute a loop that updates expectations according to a Bayesian model, the brain is rather an explorer that formulates hypotheses and tests them to assess the correspondence between internal models and reality. Moreover, the cerebral cortex is characterised by a continuous "conflict" between different brain areas, which constantly attempt to expand in order to acquire more of the limited available computational resources, by means of their dopamine-induced neuroplasticity. Thus, it has recently been suggested that dreams, during rapid eye movement sleep (REMS), protect visual brain areas (deprived of their stimuli during rest) from being conquered by other normally stimulated ones. It is therefore conceivable that positive symptoms also have a functional importance for the brain. We evaluate supporting literature data of a 'defensive' role of positive symptoms and the relevance of dopamine-induced neuroplasticity in the context of neurodegenerative and psychiatric diseases. Furthermore, the possible functional significance of idiopathic REMS-related behavioural disorder as well as phantom limb syndrome is examined. We suggest that positive neurological symptoms are not merely a passive expression of a damage, but active efforts, related to dopamine-induced plasticity, to maintain a correct relationship between the external world and its brain representation, thus preventing healthy cortical areas from ousting injured ones.
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Affiliation(s)
- Annibale Antonioni
- Doctoral Program in Translational Neurosciences and Neurotechnologies, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Ludovico Ariosto 35, 44121, Ferrara, Italy.
| | - Emanuela Maria Raho
- Department of Neuroscience and Rehabilitation, University Unit of Neurology, University of Ferrara, 44121, Ferrara, Italy
| | - Mariachiara Sensi
- Unit of Neurology, Interdistrict Health Care Department of Neuroscience, S. Anna Ferrara University Hospital, 44124, Ferrara, Italy
| | - Francesco Di Lorenzo
- Non Invasive Brain Stimulation Unit, Istituto Di Ricovero E Cura a Carattere Scientifico Santa Lucia, 00179, Rome, Italy
| | - Luciano Fadiga
- Center for Translational Neurophysiology, Istituto Italiano Di Tecnologia, 44121, Ferrara, Italy
- Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121, Ferrara, Italy
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit, Istituto Di Ricovero E Cura a Carattere Scientifico Santa Lucia, 00179, Rome, Italy
- Center for Translational Neurophysiology, Istituto Italiano Di Tecnologia, 44121, Ferrara, Italy
- Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121, Ferrara, Italy
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Donzuso G, Cicero CE, Giuliano L, Squillaci R, Luca A, Palmucci S, Basile A, Lanza G, Ferri R, Zappia M, Nicoletti A. Neuroanatomical findings in isolated REM sleep behavior disorder and early Parkinson's disease: a Voxel-based morphometry study. Brain Imaging Behav 2024; 18:83-91. [PMID: 37897654 PMCID: PMC10844466 DOI: 10.1007/s11682-023-00815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 10/30/2023]
Abstract
Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is a parasomnia characterized by loss of physiological atonia of skeletal muscles with abnormal behaviors arising during REM sleep. RBD is often the early manifestation of neurodegenerative diseases, particularly alpha-synucleinopathies, such as Parkinson's disease (PD). Both structural and functional neuroimaging studies suggest that iRBD might share, or even precede, some of the features commonly found in PD, although without a definitive conclusion. Aim of the study is to evaluate the presence of structural abnormalities involving cortical and subcortical areas in PD patients with RBD and iRBD. Patients with video-polysomnographic (VPSG)-confirmed iRBD, and patients with a diagnosis of PD were recruited. In all PD patients, the presence of probable RBD was assessed during the follow-up visits (PD/pRBD). A group of healthy controls (HC) subjects was also recruited. Each subject underwent a structural brain MRI using a 3-D T1-weighted spoiled gradient echo sequence. Twenty-three patients with iRBD, 24 PD/pRBD, and 26 HC were enrolled. Voxel-based morphometry-AnCOVA analysis revealed clusters of grey matter changes in iRBD and PD/pRBD compared to HC in several regions, involving mainly the frontal and temporal regions. The involvement of cortical brain structures associated to the control of sleep cycle and REM stage both in PD/pRBD and iRBD might suggest the presence of a common structural platform linking iRBD and PD, although this pattern may not underlie exclusively RBD-related features. Further longitudinal studies are needed to clarify the patterns of changes occurring at different time points of RBD-related neurodegeneration.
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Affiliation(s)
- Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Calogero E Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Raffaele Squillaci
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonello Basile
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Lanza
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy
| | - Raffaele Ferri
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Savoie FA, Arpin DJ, Vaillancourt DE. Magnetic Resonance Imaging and Nuclear Imaging of Parkinsonian Disorders: Where do we go from here? Curr Neuropharmacol 2024; 22:1583-1605. [PMID: 37533246 PMCID: PMC11284713 DOI: 10.2174/1570159x21666230801140648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 08/04/2023] Open
Abstract
Parkinsonian disorders are a heterogeneous group of incurable neurodegenerative diseases that significantly reduce quality of life and constitute a substantial economic burden. Nuclear imaging (NI) and magnetic resonance imaging (MRI) have played and continue to play a key role in research aimed at understanding and monitoring these disorders. MRI is cheaper, more accessible, nonirradiating, and better at measuring biological structures and hemodynamics than NI. NI, on the other hand, can track molecular processes, which may be crucial for the development of efficient diseasemodifying therapies. Given the strengths and weaknesses of NI and MRI, how can they best be applied to Parkinsonism research going forward? This review aims to examine the effectiveness of NI and MRI in three areas of Parkinsonism research (differential diagnosis, prodromal disease identification, and disease monitoring) to highlight where they can be most impactful. Based on the available literature, MRI can assist with differential diagnosis, prodromal disease identification, and disease monitoring as well as NI. However, more work is needed, to confirm the value of MRI for monitoring prodromal disease and predicting phenoconversion. Although NI can complement or be a substitute for MRI in all the areas covered in this review, we believe that its most meaningful impact will emerge once reliable Parkinsonian proteinopathy tracers become available. Future work in tracer development and high-field imaging will continue to influence the landscape for NI and MRI.
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Affiliation(s)
- Félix-Antoine Savoie
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
| | - David J. Arpin
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
| | - David E. Vaillancourt
- Department of Applied Physiology and Kinesiology, Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL, USA
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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Grimaldi S, Guye M, Bianciardi M, Eusebio A. Brain MRI Biomarkers in Isolated Rapid Eye Movement Sleep Behavior Disorder: Where Are We? A Systematic Review. Brain Sci 2023; 13:1398. [PMID: 37891767 PMCID: PMC10604962 DOI: 10.3390/brainsci13101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The increasing number of MRI studies focused on prodromal Parkinson's Disease (PD) demonstrates a strong interest in identifying early biomarkers capable of monitoring neurodegeneration. In this systematic review, we present the latest information regarding the most promising MRI markers of neurodegeneration in relation to the most specific prodromal symptoms of PD, namely isolated rapid eye movement (REM) sleep behavior disorder (iRBD). We reviewed structural, diffusion, functional, iron-sensitive, neuro-melanin-sensitive MRI, and proton magnetic resonance spectroscopy studies conducted between 2000 and 2023, which yielded a total of 77 relevant papers. Among these markers, iron and neuromelanin emerged as the most robust and promising indicators for early neurodegenerative processes in iRBD. Atrophy was observed in several regions, including the frontal and temporal cortices, limbic cortices, and basal ganglia, suggesting that neurodegenerative processes had been underway for some time. Diffusion and functional MRI produced heterogeneous yet intriguing results. Additionally, reduced glymphatic clearance function was reported. Technological advancements, such as the development of ultra-high field MRI, have enabled the exploration of minute anatomical structures and the detection of previously undetectable anomalies. The race to achieve early detection of neurodegeneration is well underway.
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Affiliation(s)
- Stephan Grimaldi
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 265 rue Saint-Pierre, 13005 Marseille, France
- Centre d’Exploration Métabolique par Résonnance Magnétique, Assistance Publique des Hôpitaux de Marseille, Hôpital Universitaire Timone, 265 rue Saint-Pierre, 13005 Marseille, France
- Center for Magnetic Resonance in Biology and Medicine, Aix Marseille University, Centre National de la Recherche Scientifique, 27 Bd Jean Moulin, 13385 Marseille, France
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, 149 13th St., Charlestown, MA 02129, USA
| | - Maxime Guye
- Centre d’Exploration Métabolique par Résonnance Magnétique, Assistance Publique des Hôpitaux de Marseille, Hôpital Universitaire Timone, 265 rue Saint-Pierre, 13005 Marseille, France
- Center for Magnetic Resonance in Biology and Medicine, Aix Marseille University, Centre National de la Recherche Scientifique, 27 Bd Jean Moulin, 13385 Marseille, France
| | - Marta Bianciardi
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, 149 13th St., Charlestown, MA 02129, USA
- Division of Sleep Medicine, Harvard University, Boston, MA 02114, USA
| | - Alexandre Eusebio
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 265 rue Saint-Pierre, 13005 Marseille, France
- Institut de Neurosciences de la Timone, Aix Marseille University, Centre National de la Recherche Scientifique, 27 Bd Jean Moulin, 13385 Marseille, France
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Zhang X, Ma L, Liang D, Song B, Chen J, Huang Y, Xu L, Zhao P, Wu W, Zhang N, Xue R. Neurofilament Light Protein Predicts Disease Progression in Idiopathic REM Sleep Behavior Disorder. JOURNAL OF PARKINSON'S DISEASE 2023:JPD223519. [PMID: 37182898 DOI: 10.3233/jpd-223519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Idiopathic rapid eye movement sleep behavior disorder (iRBD) is increasingly recognized as a manifestation preceding the α-synucleinopathies like Parkinson's disease (PD). Neurofilament light chain (NfL) have been reported to be higher in synucleinopathies as a sign of neurodegeneration. OBJECTIVE To evaluate whether plasma NfL is valuable in reflecting cognitive and motor status in iRBD and PD with a premorbid history of RBD (PDRBD), and predicting disease progression in iRBD. METHODS Thirty-one patients with iRBD, 30 with PDRBD, and 18 healthy controls were included in the cross-sectional and prospective study. Another cohort from the Parkinson's Progression Markers Initiative (PPMI) dataset was enrolled for verification analysis. All patients received evaluations of cognitive, motor, and autonomic function by a battery of clinical tests at baseline and follow-up. Blood NfL was measured by the Quanterix Simoa HD-1. RESULTS In our cohort, 26 patients with iRBD completed the follow-up evaluations, among whom eight (30.8%) patients displayed phenoconversion. Baseline plasma NfL cutoff value of 22.93 pg/mL performed best in distinguishing the iRBD converters from non-converters (sensitivity: 75.0%, specificity: 83.3%, area under the curve: 0.84). Cognitive and motor function were significantly correlated with NfL levels in PDRBD (correlation coefficients: -0.379, 0.399; respectively). Higher baseline NfL levels in iRBD were significantly associated with higher risks for cognitive, motor, autonomic function progression, and phenoconversion at follow-up (hazard ratios: 1.069, 1.065, 1.170, 1.065; respectively). The findings were supported by the PPMI dataset. CONCLUSION Plasma NfL is valuable in reflecting disease severity of PDRBD and predicting disease progression and phenoconversion in iRBD.
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Affiliation(s)
- Xuan Zhang
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Li Ma
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Danqi Liang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bingxin Song
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingshan Chen
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaqin Huang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lin Xu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Peng Zhao
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Rong Xue
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
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Lee DA, Lee HJ, Park KM. Involvement of limbic structures in patients with isolated rapid eye movement sleep behavior disorder. Sleep Biol Rhythms 2023; 21:233-240. [PMID: 38469290 PMCID: PMC10899988 DOI: 10.1007/s41105-022-00440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022]
Abstract
This study aimed to investigate the alterations in limbic structure volumes and limbic covariance network in patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD) and to compare them with healthy controls. We retrospectively enrolled 35 patients with iRBD and 35 healthy controls who underwent three-dimensional T1-weighted brain MRI. Volumetric analysis of subcortical limbic structures, including the hippocampus, amygdala, thalamus, mammillary body, hypothalamus, basal forebrain, septal nuclei, fornix, and nucleus accumbens, was performed. Furthermore, the limbic covariance network was examined using graph theory based on the limbic structure volumes. Some of the limbic structure volumes differed significantly. The right amygdala and hypothalamus volumes were lower in the patients with iRBD than in the healthy controls (0.101% vs. 0.114%, p = 0.016, and 0.027% vs. 0.030%, p = 0.045, respectively). However, there were no significant differences in the limbic covariance network between the groups. This study demonstrated that the volumes of the right amygdala and hypothalamus are lower in patients with iRBD, even without cognitive impairments, than in healthy controls. However, there were no significant differences in the limbic covariance network between the groups. The involvements of the limbic structures could be related to the conversion to neurodegenerative diseases in patients with iRBD.
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Affiliation(s)
- D. A. Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 48108 Republic of Korea
| | - H. J. Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-gu, Busan Republic of Korea
| | - K. M. Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 48108 Republic of Korea
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de Oliveira P, Martins BJ, Cardoso FEC. White matter hyperintensity presence, quantity, and location exhibits no association with motor and non-motor manifestations of PD. Parkinsonism Relat Disord 2023; 106:105245. [PMID: 36542985 DOI: 10.1016/j.parkreldis.2022.105245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Nonspecific areas of brain white matter hyperintensity (WMH) are commonly found in the elderly. Some studies have shown that the presence, quantity, and location of WMHs may be associated with the development of cognitive and motor decline in patients with Parkinson's disease (PD), but the results remain controversial. This study aimed to evaluate the relationship of WMH to motor and non-motor symptoms, including dysautonomia and rapid eye movement sleep behavior disorder (RBD), in patients with PD. METHODS Brain magnetic resonance images were acquired from 120 patients diagnosed with PD and analyzed for WMH classification and quantification. Motor symptoms were quantified using sub-scores of the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS)-III. Dysautonomia was evaluated by autonomic reactivity tests, and polysomnography was used for the diagnosis of RBD. RESULTS Age, total value of the MDS-UPDRS-III tremor sub-score, and the presence of dysautonomia were found to be linearly positively associated. Specifically, the duration of PD was positively associated with rigidity, bradykinesia, axial symptoms, prevalence of dysautonomia, and RBD sub-scores. However, in the multivariate analysis adjusted for variables of interest, no statistical significance was found for any of the models. CONCLUSION The presence, quantity, and location of WMH were not associated with the analyzed motor and non-motor manifestations of PD.
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Affiliation(s)
- Pérola de Oliveira
- SARAH Network of Rehabilitation Hospitals, Department of Neurology, Brasília, DF, Brazil
| | - Bernardo José Martins
- SARAH Network of Rehabilitation Hospitals, Department of Neurology, Brasília, DF, Brazil
| | - Francisco Eduardo Costa Cardoso
- Federal University of Minas Gerais, Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Belo Horizonte, MG, Brazil.
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Droby A, Nosatzki S, Edry Y, Thaler A, Giladi N, Mirelman A, Maidan I. The interplay between structural and functional connectivity in early stage Parkinson's disease patients. J Neurol Sci 2022; 442:120452. [PMID: 36265263 DOI: 10.1016/j.jns.2022.120452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/21/2022] [Accepted: 10/04/2022] [Indexed: 10/31/2022]
Abstract
The mechanisms underlying cognitive disturbances in Parkinson's disease (PD) are poorly understood but likely to depend on the ongoing degenerative processes affecting structural and functional connectivity (FC). This pilot study examined patterns of FC alterations during a cognitive task using EEG and structural characteristics of white matter (WM) pathways connecting these activated regions in early-stage PD. Eleven PD patients and nine healthy controls (HCs) underwent EEG recording during an auditory oddball task and MRI scans. Source localization was performed and Gaussian mixture model was fitted to identify brain regions with high power during task performance. These areas served as seed regions for connectivity analysis. FC among these regions was assessed by measures of magnitude squared coherence (MSC), and phase-locking value (PLV), while structural connectivity was evaluated using fiber tracking based on diffusion tensor imaging (DTI). The paracentral lobule (PL), superior parietal lobule (SPL), superior and middle frontal gyrus (SMFG), parahippocampal gyrus, superior and middle temporal gyri (STG, MTG) demonstrated increased activation during task performance. Compared to HCs, PD showed lower FC between SMFG and PL and between SMFG and SPL in MSC (p = 0.012 and p = 0.036 respectively). No significant differences between the groups were observed in PLV and the measured DTI metrics along WM tracts. These findings demonstrate that in early PD, cognitive performance changes might be attributed to FC alterations, suggesting that FC is affected early on in the degenerative process, whereas structural damage is more prominent in advanced stages as a result of the disease burden accumulation.
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Affiliation(s)
- Amgad Droby
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
| | - Shai Nosatzki
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel
| | - Yariv Edry
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel
| | - Avner Thaler
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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9
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Huang H, Ma X, Yue X, Kang S, Rao Y, Long W, Liang Y, Li Y, Chen Y, Lyu W, Wu J, Tan X, Qiu S. Cortical gray matter microstructural alterations in patients with type 2 diabetes mellitus. Brain Behav 2022; 12:e2746. [PMID: 36059152 PMCID: PMC9575596 DOI: 10.1002/brb3.2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/02/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND PURPOSE Neurodegenerative processes are widespread in the brains of type 2 diabetes mellitus (T2DM) patients; gaps remain to exist in the current knowledge of the associated gray matter (GM) microstructural alterations. METHODS A cross-sectional study was conducted to investigate alterations in GM microarchitecture in T2DM patients by diffusion tensor imaging and neurite orientation dispersion and density imaging (NODDI). Seventy-eight T2DM patients and seventy-four age-, sex-, and education level-matched healthy controls (HCs) without cognitive impairment were recruited. Cortical macrostructure and GM microstructure were assessed by surface-based analysis and GM-based spatial statistics (GBSS), respectively. Machine learning models were trained to evaluate the diagnostic values of cortical intracellular volume fraction (ICVF) for the classification of T2DM versus HCs. RESULTS There were no differences in cortical thickness or area between the groups. GBSS analysis revealed similar GM microstructural patterns of significantly decreased fractional anisotropy, increased mean diffusivity and radial diffusivity in T2DM patients involving the frontal and parietal lobes, and significantly lower ICVF values were observed in nearly all brain regions of T2DM patients. A support vector machine model with a linear kernel was trained to realize the T2DM versus HC classification and exhibited the highest performance among the trained models, achieving an accuracy of 74% and an area under the curve of 83%. CONCLUSIONS NODDI may help to probe the widespread GM neuritic density loss in T2DM patients occurs before measurable macrostructural alterations. The cortical ICVF values may provide valuable diagnostic information regarding the early GM microstructural alterations in T2DM.
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Affiliation(s)
- Haoming Huang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiaomeng Ma
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiaomei Yue
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Shangyu Kang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yawen Rao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Wenjie Long
- Department of Geriatrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yi Liang
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yifan Li
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yuna Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Wenjiao Lyu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Jinjian Wu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
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10
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Byun JI, Oh S, Sunwoo JS, Shin JW, Kim TJ, Jun JS, Kim HJ, Shin WC, Seong JK, Jung KY. White matter tract-specific microstructural disruption is associated with depressive symptoms in isolated RBD. Neuroimage Clin 2022; 36:103186. [PMID: 36116164 PMCID: PMC9483791 DOI: 10.1016/j.nicl.2022.103186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/23/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE White matter (WM) tract-specific changes may precede gray matter loss in isolated rapid eye movement sleep behavior disorder (iRBD). We aimed to evaluate tract-specific WM changes using tract-specific statistical analysis (TSSA) and their correlation with clinical variables in iRBD patients. METHODS This was a cross-sectional single-center study of 50 polysomnography-confirmed iRBD patients and 20 age- and sex-matched controls. We used TSSA to identify tract-specific fractional anisotropy (FA) and mean diffusivity (MD) in fourteen major fiber tracts and analyzed between-group differences in these values. Correlations between FA or MD values and clinical variables, including RBD symptom severity, depression and cognition, were evaluated. RESULTS Patients with iRBD showed lower FA in the right anterior thalamic radiation (ATR) and higher MD in the bilateral ATR and right inferior fronto-occipital fasciculus (IF-OF) than controls after adjusting for age, sex, and years of education. MD values in the IF-OF positively correlated with scores on the Korean version of the Rapid Eye Movement Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-KR, p = 0.042) and the Korean version of the geriatric depression scale (GDS-K, p = 0.002) in iRBD patients. Only GDS-K scores independently correlated with IF-OF MD values after adjusting for RBDQ-KR scores (adjusted p = 0.026). CONCLUSION This study suggests WM microstructural disruption in the bilateral ATR and right IF-OF in patients with iRBD and that alterations in the IF-OF may contribute to depressive symptoms.
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seunghwan Oh
- Department of Artificial Intelligence, Korea University, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung-Won Shin
- Department of Neurology, CHA University, CHA Bundang Medical Center, Seongnam, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of South Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Joon-Kyung Seong
- Department of Artificial Intelligence, Korea University, Seoul, South Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea; School of Biomedical Engineering, Korea University, Seoul, South Korea.
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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11
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Ota Y, Kanel P, Bohnen N. Imaging of sleep disorders in pre-Parkinsonian syndromes. Curr Opin Neurol 2022; 35:443-452. [PMID: 35788559 PMCID: PMC9308698 DOI: 10.1097/wco.0000000000001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Neuroimaging has been advanced in the last years and enabled clinicians to evaluate sleep disorders, especially isolated rapid eye movement sleep disorder (iRBD), which can be seen in alpha-synucleinopathies. iRBD is the best prodromal clinical marker for phenoconversion to these neurodegenerative diseases. This review aims to provide an update on advanced neuroimaging biomarkers in iRBD. RECENT FINDINGS Advanced structural MRI techniques, such as diffusion tensor imaging and functional MRI, neuromelanin-sensitive MRI, and scintigraphic neuroimaging such as cholinergic PET, dopamine transporter imaging - single-photon emission computerized tomography, perfusional single-photon emission computerized tomography, and cardiac metaiodobenzylguanidine can provide diagnostic and prognostic imaging biomarkers for iRBD, in isolation and more robustly when combined. SUMMARY New advanced neuroimaging can provide imaging biomarkers and aid in the appropriate clinical assessment and future therapeutic trials.
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Affiliation(s)
- Yoshiaki Ota
- The Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Prabesh Kanel
- The Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Parkinson’s Foundation Research Center of Excellence, Ann Arbor, MI, USA
| | - Nicolaas Bohnen
- The Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Parkinson’s Foundation Research Center of Excellence, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- GRECC & Neurology Service, VAAAHS, Ann Arbor, MI, USA
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12
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Ralls F, Cutchen L, Grigg-Damberger MM. What Is the Prognostic Significance of Rapid Eye Movement Sleep Without Atonia in a Polysomnogram? J Clin Neurophysiol 2022; 39:346-355. [PMID: 35239559 DOI: 10.1097/wnp.0000000000000826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY Freud said we are lucky to be paralyzed during sleep, so we cannot act out our dreams. Atonia of skeletal muscles normally present during rapid eye movement sleep prevents us from acting out our dreams. Observing rapid eye movement sleep without atonia in a polysomnogram in older adults first and foremost warrants consideration of rapid eye movement behavior disorder. Seventy-five to 90% of older adults with isolated rapid eye movement behavior disorder will develop a neurodegenerative disease within 15 years, most often a synucleinopathy. Rapid eye movement sleep without atonia in those younger than 50 years is commonly found in individuals with narcolepsy and those taking antidepressant medications.
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Affiliation(s)
- Frank Ralls
- New Mexico Sleep Labs, Rio Rancho, New Mexico, U.S.A
| | - Lisa Cutchen
- Omni Sleep, Albuquerque, New Mexico, U.S.A.; and
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13
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Rahayel S, Tremblay C, Vo A, Zheng YQ, Lehéricy S, Arnulf I, Vidailhet M, Corvol JC, Gagnon JF, Postuma RB, Montplaisir J, Lewis S, Matar E, Ehgoetz Martens K, Borghammer P, Knudsen K, Hansen A, Monchi O, Misic B, Dagher A. Brain atrophy in prodromal synucleinopathy is shaped by structural connectivity and gene expression. Brain 2022; 145:3162-3178. [PMID: 35594873 DOI: 10.1093/brain/awac187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/14/2022] Open
Abstract
Isolated REM sleep behaviour disorder (iRBD) is a synucleinopathy characterized by abnormal behaviours and vocalizations during REM sleep. Most iRBD patients develop dementia with Lewy bodies, Parkinson's disease, or multiple system atrophy over time. Patients with iRBD exhibit brain atrophy patterns that are reminiscent of those observed in overt synucleinopathies. However, the mechanisms linking brain atrophy to the underlying alpha-synuclein pathophysiology are poorly understood. Our objective was to investigate how the prion-like and regional vulnerability hypotheses of alpha-synuclein might explain brain atrophy in iRBD. Using a multicentric cohort of 182 polysomnography-confirmed iRBD patients who underwent T1-weighted MRI, we performed vertex-based cortical surface and deformation-based morphometry analyses to quantify brain atrophy in patients (67.8 years, 84% men) and 261 healthy controls (66.2 years, 75%) and investigated the morphological correlates of motor and cognitive functioning in iRBD. Next, we applied the agent-based Susceptible-Infected-Removed model (i.e., a computational model that simulates in silico the spread of pathologic alpha-synuclein based on structural connectivity and gene expression) and tested if it recreated atrophy in iRBD by statistically comparing simulated regional brain atrophy to the atrophy observed in patients. The impact of SNCA and GBA gene expression and brain connectivity was then evaluated by comparing the model fit to the one obtained in null models where either gene expression or connectivity was randomized. The results showed that iRBD patients present with cortical thinning and tissue deformation, which correlated with motor and cognitive functioning. Next, we found that the computational model recreated cortical thinning (r = 0.51, p = 0.0007) and tissue deformation (r = 0.52, p = 0.0005) in patients, and that the connectome's architecture along with SNCA and GBA gene expression contributed to shaping atrophy in iRBD. We further demonstrated that the full agent-based model performed better than network measures or gene expression alone in recreating the atrophy pattern in iRBD. In summary, atrophy in iRBD is extensive, correlates with motor and cognitive function, and can be recreated using the dynamics of agent-based modelling, structural connectivity, and gene expression. These findings support the concepts that both prion-like spread and regional susceptibility account for the atrophy observed in prodromal synucleinopathies. Therefore, the agent-based Susceptible-Infected-Removed model may be a useful tool for testing hypotheses underlying neurodegenerative diseases and new therapies aimed at slowing or stopping the spread of alpha-synuclein pathology.
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Affiliation(s)
- Shady Rahayel
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada.,Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada
| | - Christina Tremblay
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Andrew Vo
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Ying-Qiu Zheng
- Wellcome Centre for Integrative Neuroimaging, Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Stéphane Lehéricy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Isabelle Arnulf
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Marie Vidailhet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | | | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal H2X 3P2, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Neurology, Montreal General Hospital, Montreal H3G 1A4, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Montreal H3 T 1J4, Canada
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Elie Matar
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Kaylena Ehgoetz Martens
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia.,Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo N2L 3G1, Canada
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Allan Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Oury Monchi
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada.,Departments of Clinical Neurosciences, Radiology, and Hotchkiss Brain Institute, University of Calgary, Calgary T2N 4N1, Canada
| | - Bratislav Misic
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Alain Dagher
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
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14
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Chen S, Wang SH, Bai YY, Zhang JW, Zhang HJ. Comparative Study on Topological Properties of the Whole-Brain Functional Connectome in Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Parkinson’s Disease Without RBD. Front Aging Neurosci 2022; 14:820479. [PMID: 35478699 PMCID: PMC9036484 DOI: 10.3389/fnagi.2022.820479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Idiopathic rapid eye movement Sleep Behavior Disorder (iRBD) is considered as a prodromal and most valuable warning symptom for Parkinson’s disease (PD). Although iRBD and PD without RBD (nRBD-PD) are both α-synucleinopathies, whether they share the same neurodegeneration process is not clear enough. In this study, the pattern and extent of neurodegeneration were investigated and compared between early-stage nRBD-PD and iRBD from the perspective of whole-brain functional network changes. Methods Twenty-one patients with iRBD, 23 patients with early-stage nRBD-PD, and 22 matched healthy controls (HCs) were enrolled. Functional networks were constructed using resting-state functional MRI (fMRI) data. Network topological properties were analyzed and compared among groups by graph theory approaches. Correlation analyses were performed between network topological properties and cognition in the iRBD and nRBD-PD groups. Results Both patients with iRBD and patients with early-stage nRBD-PD had attention, executive function, and some memory deficits. On global topological organization, iRBD and nRBD-PD groups still presented small-worldness, but both groups exhibited decreased global/local efficiency and increased characteristic path length. On regional topological organization, compared with HC, nRBD-PD presented decreased nodal efficiency, decreased degree centrality, and increased nodal shortest path length, while iRBD presented decreased nodal efficiency and nodal shortest path. For iRBD, brain regions with decreased nodal efficiency were included in the corresponding regions of nRBD-PD. Nodal shortest path changes were significantly different in terms of brain regions and directions between nRBD-PD and iRBD. Attention deficits were correlated with local topological properties of the occipital lobe in both iRBD and nRBD-PD groups. Conclusion Both global and local efficiency of functional networks declined in nRBD-PD and iRBD groups. The overlaps and differences in local topological properties between nRBD-PD and iRBD indicate that iRBD not only shares functional changes of PD but also presents distinct features.
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15
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García-Gomar MG, Videnovic A, Singh K, Stauder M, Lewis LD, Wald LL, Rosen BR, Bianciardi M. Disruption of Brainstem Structural Connectivity in REM Sleep Behavior Disorder Using 7 Tesla Magnetic Resonance Imaging. Mov Disord 2022; 37:847-853. [PMID: 34964520 PMCID: PMC9018552 DOI: 10.1002/mds.28895] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is one of the earliest manifestations of α synucleinopathies. Brainstem pathophysiology underlying REM sleep behavior disorder has been described in animal models, yet it is understudied in living humans because of the lack of an in vivo brainstem nuclei atlas and to the limited magnetic resonance imaging (MRI) sensitivity. OBJECTIVE To investigate brainstem structural connectivity changes in iRBD patients by using an in vivo probabilistic brainstem nuclei atlas and 7 Tesla MRI. METHODS Structural connectivity of 12 iRBD patients and 12 controls was evaluated by probabilistic tractography. Two-sided Wilcoxon rank-sum test was used to compare the structural connectivity indices across groups. RESULTS In iRBD, we found impaired (Z = 2.6, P < 0.01) structural connectivity in 14 brainstem nuclei, including the connectivity between REM-on (eg, subcoeruleus [SubC]) and REM sleep muscle atonia (eg, medullary reticular formation) areas. CONCLUSIONS The brainstem nuclei diagram of impaired connectivity in human iRBD expands animal models and is a promising tool to study and possibly assess prodromal synucleinopathy stages. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- María Guadalupe García-Gomar
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Aleksandar Videnovic
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Division of Sleep Medicine, Harvard University, Boston, MA
| | - Kavita Singh
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Matthew Stauder
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Laura D. Lewis
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Lawrence L. Wald
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Bruce R. Rosen
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Marta Bianciardi
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Division of Sleep Medicine, Harvard University, Boston, MA
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16
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Chen J, Zhou L, Jiang C, Chen Z, Zhang L, Zhou H, Kang W, Jiang X, Li Y, Luo N, Yao M, Niu M, Chen S, Zuo XN, Li L, Liu J. Impaired Ocular Tracking and Cortical Atrophy in Idiopathic Rapid Eye Movement Sleep Behavior Disorder. Mov Disord 2022; 37:972-982. [PMID: 35107831 DOI: 10.1002/mds.28931] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage of synucleinopathies. Patients with synucleinopathies frequently display eye movement abnormalities. However, whether patients with iRBD have eye movement abnormalities remains unknown. OBJECTIVE The aim of this study was to assess eye movement abnormalities and related gray matter alterations and explore whether such abnormalities can serve as biomarkers to indicate phenoconversion to synucleinopathies in iRBD. METHODS Forty patients with iRBD with early disease progression and 35 healthy control subjects participated in a 15-minute ocular-tracking task that evaluated their control of eye movement abilities. They also underwent clinical assessments for olfactory function, nonmotor symptoms, and autonomic symptoms, all of which are biomarkers to predict phenoconversion to synucleinopathies in iRBD. A subgroup of the participants (20 patients with iRBD and 20 healthy control subjects) also participated in structural magnetic resonance imaging. RESULTS The ocular-tracking ability in patients with iRBD was inferior to that of healthy control subjects in two aspects: pursuit initiation and steady-state tracking. Cortical thinning in the right visual area V4 in patients with iRBD is coupled with impaired pursuit initiation. Furthermore, prolonged pursuit initiation in patients with iRBD exhibits a trend of correlation with olfactory loss, the earliest biomarker that develops prior to other prodromal biomarkers. CONCLUSIONS We found ocular-tracking abnormalities in patients with iRBD even early in their disease progression that have not been reported before. These abnormalities are coupled with atrophy of brain areas involved in the perception of object motion and might indicate phenoconversion to synucleinopathies in iRBD. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jing Chen
- Faculty of Arts and Science, New York University Shanghai, Shanghai, China
- NYU-ECNU Institute of Brain and Cognitive Science at New York University Shanghai, Shanghai, China
- Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai, China
| | - Liche Zhou
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jiang
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhichun Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lina Zhang
- Department of Biostatistics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Zhou
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyan Kang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xufeng Jiang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyuan Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningdi Luo
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengsha Yao
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengyue Niu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi-Nian Zuo
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Li
- Faculty of Arts and Science, New York University Shanghai, Shanghai, China
- NYU-ECNU Institute of Brain and Cognitive Science at New York University Shanghai, Shanghai, China
- Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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17
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Motor and non-motor circuit disturbances in early Parkinson disease: which happens first? Nat Rev Neurosci 2022; 23:115-128. [PMID: 34907352 DOI: 10.1038/s41583-021-00542-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
For the last two decades, pathogenic concepts in Parkinson disease (PD) have revolved around the toxicity and spread of α-synuclein. Thus, α-synuclein would follow caudo-rostral propagation from the periphery to the central nervous system, first producing non-motor manifestations (such as constipation, sleep disorders and hyposmia), and subsequently impinging upon the mesencephalon to account for the cardinal motor features before reaching the neocortex as the disease evolves towards dementia. This model is the prevailing theory of the principal neurobiological mechanism of disease. Here, we scrutinize the temporal evolution of motor and non-motor manifestations in PD and suggest that, even though the postulated bottom-up mechanisms are likely to be involved, early involvement of the nigrostriatal system is a key and prominent pathophysiological mechanism. Upcoming studies of detailed clinical manifestations with newer neuroimaging techniques will allow us to more closely define, in vivo, the role of α-synuclein aggregates with respect to neuronal loss during the onset and progression of PD.
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18
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Gaurav R, Pyatigorskaya N, Biondetti E, Valabrègue R, Yahia-Cherif L, Mangone G, Leu-Semenescu S, Corvol JC, Vidailhet M, Arnulf I, Lehéricy S. Deep Learning-Based Neuromelanin MRI Changes of Isolated REM Sleep Behavior Disorder. Mov Disord 2022; 37:1064-1069. [PMID: 35102604 PMCID: PMC9302679 DOI: 10.1002/mds.28933] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Isolated REM sleep behavior disorder (iRBD) is considered a prodromal stage of parkinsonism. Neurodegenerative changes in the substantia nigra pars compacta (SNc) in parkinsonism can be detected using neuromelanin‐sensitive MRI. Objective To investigate SNc neuromelanin changes in iRBD patients using fully automatic segmentation. Methods We included 47 iRBD patients, 134 early Parkinson's disease (PD) patients and 55 healthy volunteers (HVs) scanned at 3 Tesla. SNc regions‐of‐interest were delineated automatically using convolutional neural network. SNc volumes, volumes corrected by total intracranial volume, signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio were computed. One‐way general linear models (GLM) analysis of covariance (ANCOVA) was conducted while adjusting for age and sex. Results All SNc measurements differed significantly between the three groups (except SNR in iRBD). Changes in iRBD were intermediate between those in PD and HVs. Conclusions Using fully automated SNc segmentation method and neuromelanin‐sensitive imaging, iRBD patients showed neurodegenerative changes in the SNc at a lower level than in PD patients. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Rahul Gaurav
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France
| | - Nadya Pyatigorskaya
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Emma Biondetti
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France
| | - Romain Valabrègue
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Lydia Yahia-Cherif
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Graziella Mangone
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France
| | | | - Jean-Christophe Corvol
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Isabelle Arnulf
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Stéphane Lehéricy
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France
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19
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Magnetic Resonance Parkinsonism Index Is Associated with REM Sleep Behavior Disorder in Parkinson’s Disease. Brain Sci 2022; 12:brainsci12020202. [PMID: 35203966 PMCID: PMC8870674 DOI: 10.3390/brainsci12020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/17/2022] Open
Abstract
We investigated the association between the Magnetic Resonance Parkinsonism Index (MRPI) and REM sleep behavior disorder (RBD). We included 226 de novo PD patients (82 PD-RBD and 144 PD-noRBD) and 19 idiopathic RBD patients. Furthermore, 3T T1-weighted MR images were used for automated brainstem calculations. MRPI values were higher in the PD-RBD (p = 0.004) compared to PD-noRBD patients. Moreover, MRPI proved to be a significant predictor of REM Behavior Disorder Screening Questionnaire scores in PD (β = 0.195, p = 0.007) and iRBD patients (β = 0.582, p = 0.003). MRPI can be used as an imaging marker of RBD in patients with de novo PD and iRBD.
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20
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Mining imaging and clinical data with machine learning approaches for the diagnosis and early detection of Parkinson's disease. NPJ Parkinsons Dis 2022; 8:13. [PMID: 35064123 PMCID: PMC8783003 DOI: 10.1038/s41531-021-00266-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/10/2021] [Indexed: 12/14/2022] Open
Abstract
Parkinson’s disease (PD) is a common, progressive, and currently incurable neurodegenerative movement disorder. The diagnosis of PD is challenging, especially in the differential diagnosis of parkinsonism and in early PD detection. Due to the advantages of machine learning such as learning complex data patterns and making inferences for individuals, machine-learning techniques have been increasingly applied to the diagnosis of PD, and have shown some promising results. Machine-learning-based imaging applications have made it possible to help differentiate parkinsonism and detect PD at early stages automatically in a number of neuroimaging studies. Comparative studies have shown that machine-learning-based SPECT image analysis applications in PD have outperformed conventional semi-quantitative analysis in detecting PD-associated dopaminergic degeneration, performed comparably well as experts’ visual inspection, and helped improve PD diagnostic accuracy of radiologists. Using combined multi-modal (imaging and clinical) data in these applications may further enhance PD diagnosis and early detection. To integrate machine-learning-based diagnostic applications into clinical systems, further validation and optimization of these applications are needed to make them accurate and reliable. It is anticipated that machine-learning techniques will further help improve differential diagnosis of parkinsonism and early detection of PD, which may reduce the error rate of PD diagnosis and help detect PD at pre-motor stage to make it possible for early treatments (e.g., neuroprotective treatment) to slow down PD progression, prevent severe motor symptoms from emerging, and relieve patients from suffering.
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21
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Horsager J, Knudsen K, Sommerauer M. Clinical and imaging evidence of brain-first and body-first Parkinson's disease. Neurobiol Dis 2022; 164:105626. [PMID: 35031485 DOI: 10.1016/j.nbd.2022.105626] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/17/2022] Open
Abstract
Braak's hypothesis has been extremely influential over the last two decades. However, neuropathological and clinical evidence suggest that the model does not conform to all patients with Parkinson's disease (PD). To resolve this controversy, a new model was recently proposed; in brain-first PD, the initial α-synuclein pathology arise inside the central nervous system, likely rostral to the substantia nigra pars compacta, and spread via interconnected structures - eventually affecting the autonomic nervous system; in body-first PD, the initial pathological α-synuclein originates in the enteric nervous system with subsequent caudo-rostral propagation to the autonomic and central nervous system. By using REM-sleep behavior disorder (RBD) as a clinical identifier to distinguish between body-first PD (RBD-positive at motor symptom onset) and brain-first PD (RBD-negative at motor symptom onset), we explored the literature to evaluate clinical and imaging differences between these proposed subtypes. Body-first PD patients display: 1) a larger burden of autonomic symptoms - in particular orthostatic hypotension and constipation, 2) more frequent pathological α-synuclein in peripheral tissues, 3) more brainstem and autonomic nervous system involvement in imaging studies, 4) more symmetric striatal dopaminergic loss and motor symptoms, and 5) slightly more olfactory dysfunction. In contrast, only minor cortical metabolic alterations emerge before motor symptoms in body-first. Brain-first PD is characterized by the opposite clinical and imaging patterns. Patients with pathological LRRK2 genetic variants mostly resemble a brain-first PD profile whereas patients with GBA variants typically conform to a body-first profile. SNCA-variant carriers are equally distributed between both subtypes. Overall, the literature indicates that body-first and brain-first PD might be two distinguishable entities on some clinical and imaging markers.
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Affiliation(s)
- Jacob Horsager
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Sommerauer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark; Department of Neurology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Köln, Germany; Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
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22
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Burstein O, Geva R. The Brainstem-Informed Autism Framework: Early Life Neurobehavioral Markers. Front Integr Neurosci 2021; 15:759614. [PMID: 34858145 PMCID: PMC8631363 DOI: 10.3389/fnint.2021.759614] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorders (ASD) have long-term implications on functioning at multiple levels. In this perspective, we offer a brainstem-informed autism framework (BIAF) that traces the protracted neurobehavioral manifestations of ASD to early life brainstem dysfunctions. Early life brainstem-mediated markers involving functions of autonomic/arousal regulation, sleep-wake homeostasis, and sensorimotor integration are delineated. Their possible contributions to the early identification of susceptible infants are discussed. We suggest that the BIAF expands our multidimensional understanding of ASD by focusing on the early involvement of brainstem systems. Importantly, we propose an integrated BIAF screener that brings about the prospect of a sensitive and reliable early life diagnostic scheme for weighing the risk for ASD. The BIAF screener could provide clinicians substantial gains in the future and may carve customized interventions long before the current DSM ASD phenotype is manifested using dyadic co-regulation of brainstem-informed autism markers.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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23
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Rémillard-Pelchat D, Rahayel S, Gaubert M, Postuma RB, Montplaisir J, Pelletier A, Monchi O, Brambati SM, Carrier J, Gagnon JF. Comprehensive Analysis of Brain Volume in REM Sleep Behavior Disorder with Mild Cognitive Impairment. JOURNAL OF PARKINSONS DISEASE 2021; 12:229-241. [PMID: 34690149 DOI: 10.3233/jpd-212691] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Rapid-eye-movement sleep behavior disorder (RBD) is a major risk factor for Parkinson's disease and dementia with Lewy bodies. More than a third of RBD patients have mild cognitive impairment (MCI), but their specific structural brain alterations remain poorly understood. OBJECTIVE This study aimed to investigate the local deformation and volume of gray and white matter tissue underlying MCI in RBD. METHODS Fifty-two idiopathic RBD patients, including 17 with MCI (33%), underwent polysomnography, neuropsychological, neurological, and magnetic resonance imaging assessments. MCI diagnosis was based on a subjective complaint, cognitive impairment on the neuropsychological battery, and preserved daily functioning. Forty-one controls were also included. Deformation-based morphometry (DBM), voxel-based morphometry (VBM), and regional volume analyses of the corpus callosum and basal forebrain cholinergic were performed. Multiple regressions models were also computed using anatomical, cognitive (composite z score), and motor parameters. RESULTS Globally, patients with MCI displayed a widespread pattern of local deformation and volume atrophy in the cortical (bilateral insula, cingulate cortex, precuneus, frontal and temporal regions, right angular gyrus, and mid-posterior segment of the corpus callosum) and subcortical (brainstem, corona radiata, basal ganglia, thalamus, amygdala, and right hippocampus) regions compared to patients without MCI (DBM) or controls (DBM and VBM). Moreover, brain deformation (DBM) in patients were associated with lower performance in attention and executive functions, visuospatial abilities, and higher motor symptoms severity. CONCLUSION The present study identified novel brain structural alterations in RBD patients with MCI which correlated with poorer cognitive performance. These results are consistent with those reported in patients with synucleinopathies-related cognitive impairment.
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Affiliation(s)
- David Rémillard-Pelchat
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Shady Rahayel
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Malo Gaubert
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Ronald B Postuma
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Amélie Pelletier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Oury Monchi
- Department of Radiology, Radio-Oncology, and Nuclear Medicine, Université de Montréal, Montreal, Quebec, Canada.,Departments of Clinical Neurosciences, Radiology, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Simona Maria Brambati
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal -Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
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24
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Mitchell T, Lehéricy S, Chiu SY, Strafella AP, Stoessl AJ, Vaillancourt DE. Emerging Neuroimaging Biomarkers Across Disease Stage in Parkinson Disease: A Review. JAMA Neurol 2021; 78:1262-1272. [PMID: 34459865 PMCID: PMC9017381 DOI: 10.1001/jamaneurol.2021.1312] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Imaging biomarkers in Parkinson disease (PD) are increasingly important for monitoring progression in clinical trials and also have the potential to improve clinical care and management. This Review addresses a critical need to make clear the temporal relevance for diagnostic and progression imaging biomarkers to be used by clinicians and researchers over the clinical course of PD. Magnetic resonance imaging (diffusion imaging, neuromelanin-sensitive imaging, iron-sensitive imaging, T1-weighted imaging), positron emission tomography/single-photon emission computed tomography dopaminergic, serotonergic, and cholinergic imaging as well as metabolic and cerebral blood flow network neuroimaging biomarkers in the preclinical, prodromal, early, and moderate to late stages are characterized. Observations If a clinical trial is being carried out in the preclinical and prodromal stages, potentially useful disease-state biomarkers include dopaminergic imaging of the striatum; metabolic imaging; free-water, neuromelanin-sensitive, and iron-sensitive imaging in the substantia nigra; and T1-weighted structural magnetic resonance imaging. Disease-state biomarkers that can distinguish atypical parkinsonisms are metabolic imaging, free-water imaging, and T1-weighted imaging; dopaminergic imaging and other molecular imaging track progression in prodromal patients, whereas other established progression biomarkers need to be evaluated in prodromal cohorts. Progression in early-stage PD can be monitored using dopaminergic imaging in the striatum, metabolic imaging, and free-water and neuromelanin-sensitive imaging in the posterior substantia nigra. Progression in patients with moderate to late-stage PD can be monitored using free-water imaging in the anterior substantia nigra, R2* of substantia nigra, and metabolic imaging. Cortical thickness and gyrification might also be useful markers or predictors of progression. Dopaminergic imaging and free-water imaging detect progression over 1 year, whereas other modalities detect progression over 18 months or longer. The reliability of progression biomarkers varies with disease stage, whereas disease-state biomarkers are relatively consistent in individuals with preclinical, prodromal, early, and moderate to late-stage PD. Conclusions and Relevance Imaging biomarkers for various stages of PD are readily available to be used as outcome measures in clinical trials and are potentially useful in multimodal combination with routine clinical assessment. This Review provides a critically important template for considering disease stage when implementing diagnostic and progression biomarkers in both clinical trials and clinical care settings.
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Affiliation(s)
- Trina Mitchell
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville
| | - Stéphane Lehéricy
- Paris Brain Institute, Centre de NeuroImagerie de Recherche, INSERM 1127, CNRS 7225, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Shannon Y Chiu
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville
| | - Antonio P Strafella
- Division of Brain, Imaging and Behaviour-Systems Neuroscience, Krembil Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Research Imaging Centre, Campbell Family Mental Health, Toronto, Ontario, Canada
- Morton and Gloria Shulman Movement Disorder Unit and E.J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and Parkinson's Foundation Centre of Excellence, Division of Neurology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - David E Vaillancourt
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville
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25
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Chung SJ, Cho KH, Lee YH, Yoo HS, Baik K, Jung JH, Ye BS, Sohn YH, Cha J, Lee PH. Diffusion tensor imaging-based pontine damage as a degeneration marker in synucleinopathy. J Neurosci Res 2021; 99:2922-2931. [PMID: 34521154 DOI: 10.1002/jnr.24926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/25/2021] [Accepted: 07/02/2021] [Indexed: 11/08/2022]
Abstract
The pons is one of the earliest affected regions in patients with synucleinopathies. We aimed to investigate the diagnostic value of measuring pontine damage using diffusion tensor imaging (DTI) in these patients. We enrolled 49 patients with Parkinson's disease (PD), 16 patients with idiopathic rapid eye movement sleep behavior disorder (iRBD), 23 patients with multiple system atrophy (MSA), and 39 healthy controls in this study. All the participants underwent high-resolution T1-weighted imaging and DTI. Mean diffusivity (MD) and fraction anisotropy (FA) values in the pons were calculated to characterize structural damage. The discriminatory power of pontine MD and FA values to differentiate patients with synucleinopathies from healthy controls was examined using receiver operating characteristics (ROC) analyses. Compared to healthy controls, patients with PD, iRBD, and MSA had increased MD values and decreased FA values in the pons, although no correlation was observed between these DTI measures and disease severity. The ROC analyses showed that MD values in the pons had a fair discriminatory power to differentiate healthy controls from patients with PD (area under the curve [AUC], 0.813), iRBD (AUC, 0.779), and MSA (AUC, 0.951). The AUC for pontine FA values was smaller than that for pontine MD values when differentiating healthy controls from patients with PD (AUC, 0.713; p = 0.054) and iRBD (AUC, 0.686; p = 0.045). Our results suggest that MD values in the pons may be a useful marker of brain stem neurodegeneration in patients with synucleinopathies.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Kyoo Ho Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - KyoungWon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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26
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Neurochemical Features of Rem Sleep Behaviour Disorder. J Pers Med 2021; 11:jpm11090880. [PMID: 34575657 PMCID: PMC8468296 DOI: 10.3390/jpm11090880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/13/2022] Open
Abstract
Dopaminergic deficiency, shown by many studies using functional neuroimaging with Single Photon Emission Computerized Tomography (SPECT) and Positron Emission Tomography (PET), is the most consistent neurochemical feature of rapid eye movement (REM) sleep behaviour disorder (RBD) and, together with transcranial ultrasonography, and determination of alpha-synuclein in certain tissues, should be considered as a reliable marker for the phenoconversion of idiopathic RBD (iRBD) to a synucleopathy (Parkinson’s disease –PD- or Lewy body dementia -LBD). The possible role in the pathogenesis of RBD of other neurotransmitters such as noradrenaline, acetylcholine, and excitatory and inhibitory neurotransmitters; hormones such as melatonin, and proinflammatory factors have also been suggested by recent reports. In general, brain perfusion and brain glucose metabolism studies have shown patterns resembling partially those of PD and LBD. Finally, the results of structural and functional MRI suggest the presence of structural changes in deep gray matter nuclei, cortical gray matter atrophy, and alterations in the functional connectivity within the basal ganglia, the cortico-striatal, and the cortico-cortical networks, but they should be considered as preliminary.
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Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, C/Marroquina 14, 3 B, E28030 Madrid, Spain;
- Correspondence: or ; Tel.: +34-636968395; Fax: +34-913280704
| | - Hortensia Alonso-Navarro
- Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, C/Marroquina 14, 3 B, E28030 Madrid, Spain;
| | - Elena García-Martín
- UNEx, ARADyAL, Instituto de Salud Carlos III, University Institute of Molecular Pathology, E10071 Cáceres, Spain; (E.G.-M.); (J.A.G.A.)
| | - José A. G. Agúndez
- UNEx, ARADyAL, Instituto de Salud Carlos III, University Institute of Molecular Pathology, E10071 Cáceres, Spain; (E.G.-M.); (J.A.G.A.)
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27
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Application of machine learning analysis based on diffusion tensor imaging to identify REM sleep behavior disorder. Sleep Breath 2021; 26:633-640. [PMID: 34236578 DOI: 10.1007/s11325-021-02434-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE We evaluated the feasibility of machine learning analysis using diffusion tensor imaging (DTI) parameters to identify patients with idiopathic rapid eye movement (REM) sleep behavior disorder (RBD). We hypothesized that patients with idiopathic RBD could be identified via machine learning analysis based on DTI. METHODS We enrolled 20 patients with newly diagnosed idiopathic RBD at a tertiary hospital. We also included 20 healthy subjects as a control group. All of the subjects underwent DTI. We obtained the conventional DTI parameters and structural connectomic profiles from the DTI. We investigated the differences in conventional DTI measures and structural connectomic profiles between patients with idiopathic RBD and healthy controls. We then used machine learning analysis using a support vector machine (SVM) algorithm to identify patients with idiopathic RBD using conventional DTI and structural connectomic profiles. RESULTS Several regions showed significant differences in conventional DTI measures and structural connectomic profiles between patients with idiopathic RBD and healthy controls. The SVM classifier based on conventional DTI measures revealed an accuracy of 87.5% and an area under the curve of 0.900 to identify patients with idiopathic RBD. Another SVM classifier based on structural connectomic profiles yielded an accuracy of 75.0% and an area under the curve of 0.833. CONCLUSION Our findings demonstrate the feasibility of machine learning analysis based on DTI to identify patients with idiopathic RBD. The conventional DTI parameters might be more important than the structural connectomic profiles in identifying patients with idiopathic RBD.
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28
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Wang YQ, Liu WY, Li L, Qu WM, Huang ZL. Neural circuitry underlying REM sleep: A review of the literature and current concepts. Prog Neurobiol 2021; 204:102106. [PMID: 34144122 DOI: 10.1016/j.pneurobio.2021.102106] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/25/2021] [Accepted: 06/09/2021] [Indexed: 01/09/2023]
Abstract
As one of the fundamental sleep states, rapid eye movement (REM) sleep is believed to be associated with dreaming and is characterized by low-voltage, fast electroencephalographic activity and loss of muscle tone. However, the mechanisms of REM sleep generation have remained unclear despite decades of research. Several models of REM sleep have been established, including a reciprocal interaction model, limit-cycle model, flip-flop model, and a model involving γ-aminobutyric acid, glutamate, and aminergic/orexin/melanin-concentrating hormone neurons. In the present review, we discuss these models and summarize two typical disorders related to REM sleep, namely REM sleep behavior disorder and narcolepsy. REM sleep behavior disorder is a sleep muscle-tone-related disorder and can be treated with clonazepam and melatonin. Narcolepsy, with core symptoms of excessive daytime sleepiness and cataplexy, is strongly connected with orexin in early adulthood.
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Affiliation(s)
- Yi-Qun Wang
- Department of Pharmacology, School of Basic Medical Sciences and State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Wen-Ying Liu
- Department of Pharmacology, School of Basic Medical Sciences and State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Lei Li
- Department of Pharmacology, School of Basic Medical Sciences and State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences and State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences and State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China.
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Yang Y, Ye C, Sun J, Liang L, Lv H, Gao L, Fang J, Ma T, Wu T. Alteration of brain structural connectivity in progression of Parkinson's disease: A connectome-wide network analysis. Neuroimage Clin 2021; 31:102715. [PMID: 34130192 PMCID: PMC8209844 DOI: 10.1016/j.nicl.2021.102715] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/08/2021] [Accepted: 05/31/2021] [Indexed: 12/12/2022]
Abstract
Pinpointing the brain dysconnectivity in idiopathic rapid eye movement sleep behaviour disorder (iRBD) can facilitate preventing the conversion of Parkinson's disease (PD) from prodromal phase. Recent neuroimage investigations reported disruptive brain white matter connectivity in both iRBD and PD, respectively. However, the intrinsic process of the human brain structural network evolving from iRBD to PD still remains largely unknown. To address this issue, 151 participants including iRBD, PD and age-matched normal controls were recruited to receive diffusion MRI scans and neuropsychological examinations. The connectome-wide association analysis was performed to detect reorganization of brain structural network along with PD progression. Eight brain seed regions in both cortical and subcortical areas demonstrated significant structural pattern changes along with the progression of PD. Applying machine learning on the key connectivity related to these seed regions demonstrated better classification accuracy compared to conventional network-based statistic. Our study shows that connectome-wide association analysis reveals the underlying structural connectivity patterns related to the progression of PD, and provide a promising distinct capability to predict prodromal PD patients.
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Affiliation(s)
- Yanwu Yang
- Department of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China
| | | | - Junyan Sun
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disease, Beijing, China
| | - Li Liang
- Department of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China
| | - Haiyan Lv
- MindsGo Shenzhen Life Science Co. Ltd, Shenzhen, China
| | - Linlin Gao
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disease, Beijing, China
| | - Jiliang Fang
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ting Ma
- Department of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China; Peng Cheng Laboratory, Shenzhen, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing, China.
| | - Tao Wu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disease, Beijing, China.
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Holtbernd F, Romanzetti S, Oertel WH, Knake S, Sittig E, Heidbreder A, Maier A, Krahe J, Wojtala J, Dogan I, Schulz JB, Schiefer J, Janzen A, Reetz K. Convergent patterns of structural brain changes in rapid eye movement sleep behavior disorder and Parkinson's disease on behalf of the German rapid eye movement sleep behavior disorder study group. Sleep 2021; 44:5911473. [PMID: 32974664 DOI: 10.1093/sleep/zsaa199] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/08/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Rapid eye movement sleep behavior disorder (RBD) is considered a prodromal state of Parkinson's disease (PD). We aimed to characterize patterns of structural brain changes in RBD and PD patients using multimodal MRI. METHODS A total of 30 patients with isolated RBD, 29 patients with PD, and 56 age-matched healthy controls (HC) underwent MRI at 3T, including tensor-based morphometry, diffusion tensor imaging, and assessment of cortical thickness. RESULTS RBD individuals showed increased volume of the right caudate nucleus compared with HC, and higher cerebellar volume compared with both PD subjects and HC. Similar to PD subjects, RBD patients displayed increased fractional anisotropy (FA) in the corticospinal tracts, several tracts mainly related to non-motor function, and reduced FA of the corpus callosum compared with HC. Further, RBD subjects showed higher FA in the cerebellar peduncles and brainstem compared with both, PD patients and HC. PD individuals exhibited lower than normal volume in the basal ganglia, midbrain, pedunculopontine nuclei, and cerebellum. In contrast, volume in PD subjects was increased in the thalamus compared with both HC and RBD subjects. CONCLUSIONS We found convergent patterns of structural brain alterations in RBD and PD patients compared with HC. The changes observed suggest a co-occurrence of neurodegeneration and compensatory mechanisms that fail with emerging PD pathology. Our findings strengthen the hypothesis of RBD and PD constituting a continuous disease spectrum.
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Affiliation(s)
- Florian Holtbernd
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine 4 (INM-4), Juelich Research Center, Juelich, Germany
| | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | | | - Susanne Knake
- Department of Neurology, Philipps-University Marburg, Marburg, Germany.,CMBB, Center for Mind, Brain and Behavior, University Hospital Marburg, Marburg, Germany
| | - Elisabeth Sittig
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Anna Heidbreder
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany.,Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Andrea Maier
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Janna Krahe
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Jennifer Wojtala
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Jörg Bernhard Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | | | - Annette Janzen
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
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31
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Campabadal A, Segura B, Junque C, Iranzo A. Structural and functional magnetic resonance imaging in isolated REM sleep behavior disorder: A systematic review of studies using neuroimaging software. Sleep Med Rev 2021; 59:101495. [PMID: 33979733 DOI: 10.1016/j.smrv.2021.101495] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022]
Abstract
Isolated rapid eye movement sleep behavior disorder (iRBD) is a harbinger for developing clinical synucleinopathies. Magnetic resonance imaging (MRI) has been suggested as a tool for understanding the brain bases of iRBD and its evolution. This review systematically analyzed original full text articles on structural and functional MRI in patients with video-polysomnography-confirmed iRBD according to systematic procedures suggested by Reviews and Meta-analyses (PRISMA). The literature search was conducted via the PubMed database for articles related to structural and functional MRI in iRBD from 2000 to 2020. Investigations to date have been diverse in terms of methodology, but most agree that patients with iRBD have structural changes in deep gray matter nuclei, cortical gray matter atrophy, and disrupted functional connectivity within the basal ganglia, the cortico-striatal and cortico-cortical networks. Furthermore, there is evidence that MRI detects structural and functional brain changes associated with the motor and non-motor symptoms of iRBD. The current review highlights the need for larger multicenter and longitudinal studies, using complex approaches based on data-driven and unsupervised machine learning that will help to identify structural and functional patterns of brain degeneration. In turn, this may even allow for the prediction of subsequent phenoconversion from iRBD to the clinically defined synucleinopathies.
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Affiliation(s)
- Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain.
| | - Alex Iranzo
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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32
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Marques A, Roquet D, Matar E, Taylor NL, Pereira B, O'Callaghan C, Lewis SJG. Limbic hypoconnectivity in idiopathic REM sleep behaviour disorder with impulse control disorders. J Neurol 2021; 268:3371-3380. [PMID: 33709218 DOI: 10.1007/s00415-021-10498-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Current neuroimaging research has revealed several brain alterations in idiopathic REM sleep behaviour disorder (iRBD) that mirror and precede those reported in PD. However, none have specifically addressed the presence of changes across the reward system, and their role in the emergence of impulse control disorders (ICDs). We aimed to compare the volumetric and functional connectivity characteristics of the reward system in relation to the psychobehavioral profile of patients with iRBD versus healthy controls and PD patients. METHODS Twenty patients with polysomnography confirmed iRBD along with 17 PD patients and 14 healthy controls (HC) underwent structural and functional resting-state brain MRI analysis. Participants completed the questionnaire for impulsive-compulsive disorders in PD (QUIP), the short UPPS-P impulsive behaviour scale, as well as neuropsychological testing of cognitive function. RESULTS A higher percentage of iRBD patients reported hypersexuality, compared to HC and PD (p = 0.008). Whole-brain and striatal voxel-based morphometry analyses showed no significant clusters of reduced grey matter volume between groups. However, iRBD compared to HC demonstrated functional hypoconnectivity between the limbic striatum and temporo-occipital regions. Furthermore, the presence of ICDs correlated with hypoconnectivity between the limbic striatum and clusters located in cuneus, lingual and fusiform gyrus. CONCLUSION Altered functional connectivity between the limbic striatum and posterior cortical regions was associated with increased hypersexuality in iRBD. It is possible that this change may ultimately predispose individuals to the emergence of ICDs when they receive dopaminergic medications, after transitioning to PD.
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Affiliation(s)
- Ana Marques
- Brain and Mind Center, School of Medical Sciences, University of Sydney, Forefront Parkinson's Disease Research Clinic, Sydney, Australia.
- Neurology department, Université Clermont-Auvergne, Clermont-Ferrand University Hospital, EA7280, Clermont-Ferrand, France.
| | - Daniel Roquet
- Frontiers, Brain and Mind Center, University of Sydney, Sydney, Australia
| | - Elie Matar
- Brain and Mind Center, School of Medical Sciences, University of Sydney, Forefront Parkinson's Disease Research Clinic, Sydney, Australia
| | - Natasha Louise Taylor
- Brain and Mind Center, School of Medical Sciences, University of Sydney, Forefront Parkinson's Disease Research Clinic, Sydney, Australia
| | - Bruno Pereira
- Biostatistics Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Claire O'Callaghan
- Brain and Mind Center, School of Medical Sciences, University of Sydney, Forefront Parkinson's Disease Research Clinic, Sydney, Australia
| | - Simon J G Lewis
- Brain and Mind Center, School of Medical Sciences, University of Sydney, Forefront Parkinson's Disease Research Clinic, Sydney, Australia
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Valli M, Cho SS, Masellis M, Chen R, Koshimori Y, Diez-Cirarda M, Mihaescu A, Christopher L, Strafella AP. Extra-striatal dopamine in Parkinson's disease with rapid eye movement sleep behavior disorder. J Neurosci Res 2021; 99:1177-1187. [PMID: 33470445 DOI: 10.1002/jnr.24779] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 11/05/2022]
Abstract
Rapid eye movement sleep behavior disorder (RBD) is a common condition found in more than 50% of the patients with Parkinson's disease (PD). Molecular imaging shows that PD with RBD (PD-RBD+) have lower striatal dopamine transporter activity within the caudate and putamen relative to PD without RBD (PD-RBD-). However, the characterization of the extra-striatal dopamine within the mesocortical and mesolimbic pathways remains unknown. We aim to elucidate this with PET imaging in 15 PD-RBD+ and 15 PD-RBD- patients, while having 15 age-matched healthy controls (HC). Each participant underwent a single PET scan with [11 C]FLB-457 to detect the D2 receptor availability within the extra-striatal regions of interest (ROI), including the prefrontal, temporal, and limbic areas. [11 C]FLB-457 retention was expressed as the nondisplaceable binding potential. Our results reveal that relative to HC, PD-RBD+ and PD-RBD- patients have lower levels of D2 receptor availability within the uncus parahippocampus, superior, lateral, and inferior temporal cortex. PD-RBD+ showed steep decline in D2 receptors within the left uncus parahippocampus with increasing disease severity, but this was not observed for PD-RBD- patients. Findings imply that extra-striatal dopaminergic system may play a role in contributing to symptomatic progress in PD patients with RBD. However, validation with more advanced PD patients are needed.
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Affiliation(s)
- Mikaeel Valli
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, ON, Canada
| | - Sang Soo Cho
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada
| | - Mario Masellis
- Institute of Medical Science, University of Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Robert Chen
- Krembil Research Institute, University Health Network, University of Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, ON, Canada.,Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, Toronto Western Hospital, UHN, University of Toronto, ON, Canada
| | - Yuko Koshimori
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Music and Health Research Collaboratory (MaRC), Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Maria Diez-Cirarda
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada.,Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Alexander Mihaescu
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, ON, Canada
| | - Leigh Christopher
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada
| | - Antonio P Strafella
- Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, ON, Canada.,Krembil Research Institute, University Health Network, University of Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, ON, Canada.,Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, Toronto Western Hospital, UHN, University of Toronto, ON, Canada
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Cognitive and Neuropsychiatric Profiles in Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Parkinson's Disease. J Pers Med 2021; 11:jpm11010051. [PMID: 33467021 PMCID: PMC7830588 DOI: 10.3390/jpm11010051] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 11/17/2022] Open
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is a risk factor for developing Parkinson’s disease (PD) and may represent its prodromal state. We compared neuropsychological and neuropsychiatric phenotypes of idiopathic (i) RBD, PD and healthy comparators (HC) in order to identify iRBD specific characteristics. Thirty-eight patients with iRBD, 38 PD patients with RBD (PD + RBD), 38 PD patients without RBD (PD-RBD) and 38 HC underwent a comprehensive neurological, neuropsychological and neuropsychiatric evaluation. iRBD, PD + RBD and PD-RBD performed worse than HC in short-term verbal memory, praxia, language and executive functions. iRBD had higher levels of anxiety, depression, apathy and alexithymia than HC. iRBD had higher levels of apathy than PD + RBD. Both PD groups had higher levels of anxiety and depression than HC. Surprisingly, iRBD performed better than all groups in long-term verbal memory. Patients diagnosed with iRBD are characterized by poor global cognitive performance, but better long-term memory and higher levels of depression, anxiety, alexithymia and apathy. Alexithymia and apathy in patients diagnosed with iRBD may be the expression of precocious derangement of emotional regulation, subsequently observed also in PD. Cognitive and neuropsychiatric symptoms of iRBD are early clinical manifestations of widespread neurodegeneration.
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Rahayel S, Postuma RB, Montplaisir J, Mišić B, Tremblay C, Vo A, Lewis S, Matar E, Ehgoetz Martens K, Blanc F, Yao C, Carrier J, Monchi O, Gaubert M, Dagher A, Gagnon JF. A Prodromal Brain-Clinical Pattern of Cognition in Synucleinopathies. Ann Neurol 2020; 89:341-357. [PMID: 33217037 DOI: 10.1002/ana.25962] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Isolated (or idiopathic) rapid eye movement sleep behavior disorder (iRBD) is associated with dementia with Lewy bodies (DLB) and Parkinson's disease (PD). Biomarkers are lacking to predict conversion to a dementia or a motor-first phenotype. Here, we aimed at identifying a brain-clinical signature that predicts dementia in iRBD. METHODS A brain-clinical signature was identified in 48 patients with polysomnography-confirmed iRBD using partial least squares between brain deformation and 27 clinical variables. The resulting variable was applied to 78 patients with iRBD followed longitudinally to predict conversion to a synucleinopathy, specifically DLB. The deformation scores from patients with iRBD were compared with 207 patients with PD, DLB, or prodromal DLB to assess if scores were higher in DLB compared to PD. RESULTS One latent variable explained 31% of the brain-clinical covariance in iRBD, combining cortical and subcortical deformation and subarachnoid/ventricular expansion to cognitive and motor variables. The deformation score of this signature predicted conversion to a synucleinopathy in iRBD (p = 0.036, odds ratio [OR] = 2.249; 95% confidence interval [CI] = 1.053-4.803), specifically to DLB (OR = 4.754; 95% CI = 1.283-17.618, p = 0.020) and not PD (p = 0.286). Patients with iRBD who developed dementia had scores similar to clinical and prodromal patients with DLB but higher scores compared with patients with PD. The deformation score also predicted cognitive performance over 1, 2, and 4 years in patients with PD. INTERPRETATION We identified a brain-clinical signature that predicts conversion in iRBD to more severe/dementing forms of synucleinopathy. This pattern may serve as a new biomarker to optimize patient care, target risk reduction strategies, and administer neuroprotective trials. ANN NEUROL 2021;89:341-357.
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Affiliation(s)
- Shady Rahayel
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.,Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Ronald B Postuma
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,Department of Neurology, Montreal General Hospital, Montreal, QC, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Bratislav Mišić
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Christina Tremblay
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrew Vo
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Elie Matar
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Kaylena Ehgoetz Martens
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Frédéric Blanc
- ICube Laboratory and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Team IMIS, Université de Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospital of Strasbourg, CM2R (Memory Resource and Research Centre), Day Hospital, Strasbourg, France
| | - Chun Yao
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Oury Monchi
- Departments of Clinical Neurosciences, Radiology, and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Radiology, Radio-Oncology, and Nuclear Medicine, Université de Montréal, Montreal, QC, Canada
| | - Malo Gaubert
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Alain Dagher
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jean-François Gagnon
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
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Li G, Chen Z, Zhou L, Yao M, Luo N, Kang W, Chen S, Liu J. Abnormal intrinsic brain activity of the putamen is correlated with dopamine deficiency in idiopathic rapid eye movement sleep behavior disorder. Sleep Med 2020; 75:73-80. [DOI: 10.1016/j.sleep.2019.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/20/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022]
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Shin JH, Lee JY, Kim YK, Shin SA, Kim H, Nam H, Jeon B. Longitudinal change in dopamine transporter availability in idiopathic REM sleep behavior disorder. Neurology 2020; 95:e3081-e3092. [DOI: 10.1212/wnl.0000000000010942] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo elucidate longitudinal changes in the dopamine transporter (DAT) availability in association with the prodromal markers in idiopathic REM sleep behavior disorder (iRBD), we analyzed a longitudinal prospective iRBD cohort data.MethodThe study cohort consisted of patients with iRBD, individuals with Parkinson disease (PD), and healthy controls. All participants were evaluated for olfaction, neuropsychological tests, and the Movement Disorders Society–Unified Parkinson's Disease Rating Scale and underwent 18F-FP-CIT PET scans every 2 years. We calculated the DAT pattern by performing the principal component analysis of tracer uptakes in 6 striatal regions.ResultDAT patterns in patients with iRBD with baseline hyposmia, constipation, and mild parkinsonian signs distributed toward the PD pattern and clearly distinguished from the healthy control pattern. The DAT pattern moved toward the PD pattern over time in some patients with iRBD during the follow-up, and baseline hyposmia was the only biomarker significantly associated with this change. Baseline PD pattern of DAT predicted 58% of disease converters (hazard ratio 4.95 [95% confidence interval 1.16–21.08]). The combination of hyposmia and baseline PD pattern of DAT predicted 67% of the conversion (hazard ratio 7.89 [confidence interval 1.85–33.69]). The estimated sample size required for a simulated neuroprotective clinical trial was 63 per group when the annual change of DAT pattern was used as an outcome in the subgroup with baseline DAT PD pattern and hyposmia, which is the smallest number reported so far.ConclusionBaseline and longitudinal monitoring of the DAT pattern can be a useful biomarker in identifying individuals with a high risk of disease conversion and in selecting the potential population for clinical trials in iRBD.
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Campabadal A, Inguanzo A, Segura B, Serradell M, Abos A, Uribe C, Gaig C, Santamaria J, Compta Y, Bargallo N, Junque C, Iranzo A. Cortical gray matter progression in idiopathic REM sleep behavior disorder and its relation to cognitive decline. NEUROIMAGE-CLINICAL 2020; 28:102421. [PMID: 32957013 PMCID: PMC7509231 DOI: 10.1016/j.nicl.2020.102421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/24/2022]
Abstract
Cortical degeneration over time in IRBD patients is larger than in normal aging. IRBD patients have progressive parieto-occipital and orbitofrontal thinning. Visuospatial decline in IRBD is associated with degeneration in parietal regions. Increasing motor signs in IRBD are related to frontal and parietal degeneration. Cortical thinning in posterior regions is associated with late-onset IRBD.
Background Idiopathic Rapid eye movement sleep behavior disorder (IRBD) is recognized as the prodromal stage of the alpha-Synucleinopathies. Although some studies have addressed the characterization of brain structure in IRBD, little is known about its progression. Objective The present work aims at further characterizing gray matter progression throughout IRBD relative to normal aging and investigating how these changes are associated with cognitive decline. Methods Fourteen patients with polysomnography-confirmed IRBD and 18 age-matched healthy controls (HC) underwent neuropsychological, olfactory, motor, and T1-weighted MRI evaluation at baseline and follow-up. We compared the evolution of cortical thickness (CTh), subcortical volumes, smell, motor and cognitive performance in IRBD and HC after a mean of 1.6 years. FreeSurfer was used for CTh and volumetry preprocessing and analyses. The symmetrized percent of change (SPC) of the CTh was correlated with the SPC of motor and neuropsychological performance. Results IRBD and HC differed significantly in the cortical thinning progression in regions encompassing bilateral superior parietal and precuneus, the right cuneus, the left occipital pole and lateral orbitofrontal gyri (FWE corrected, p < 0.05). The Visual form discrimination test showed worse progression in the IRBD relative to HC, that was associated with gray matter loss in the right superior parietal and the left precuneus. Increasing motor signs in IRBD were related to cortical thinning mainly involving frontal regions, and late-onset IRBD was associated with cortical thinning involving posterior areas (FWE corrected, p < 0.05). Despite finding olfactory identification deficits in IRBD, results did not show decline over the disease course. Conclusion Progression in IRBD patients is characterized by parieto-occipital and orbitofrontal thinning and visuospatial loss. The cognitive decline in IRBD is associated with degeneration in parietal regions.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - A Inguanzo
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain
| | - M Serradell
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Gaig
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - J Santamaria
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Y Compta
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Parkinson's Disease & Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain.
| | - A Iranzo
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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Alzaid H, Ethofer T, Hobert MA, Kardatzki B, Erb M, Maetzler W, Berg D. Distinct Relationship Between Cognitive Flexibility and White Matter Integrity in Individuals at Risk of Parkinson’s Disease. Front Aging Neurosci 2020; 12:250. [PMID: 32903902 PMCID: PMC7439016 DOI: 10.3389/fnagi.2020.00250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Haidar Alzaid
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
- *Correspondence: Haidar Alzaid,
| | - Thomas Ethofer
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Markus A. Hobert
- Department of Neurology, Christian-Albrecht University of Kiel, Kiel, Germany
| | - Bernd Kardatzki
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrecht University of Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrecht University of Kiel, Kiel, Germany
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Yang C, Chang J, Liang X, Bao X, Wang R. Gray Matter Alterations in Parkinson's Disease With Rapid Eye Movement Sleep Behavior Disorder: A Meta-Analysis of Voxel-Based Morphometry Studies. Front Aging Neurosci 2020; 12:213. [PMID: 32903450 PMCID: PMC7434963 DOI: 10.3389/fnagi.2020.00213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/17/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Gray matter (GM) alterations in Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) have been demonstrated in many neuroimaging studies using voxel-based morphometry (VBM). However, the inconsistent findings between studies cannot be applied to clinical practice as a neuroimaging biomarker. We performed a meta-analysis of VBM studies at a whole-brain level to investigate GM differences between PD patients with and without RBD. Methods: A systematic search was conducted in PubMed, Embase, and Web of Science from inception to November 2019 to identify eligible VBM studies. We adopted the latest Seed-based d Mapping with Permutation of Subject Images technique to quantitatively estimate the difference of regional GM volume between PD patients with and without RBD. Results: We included five studies comprising 105 PD patients with RBD and 140 PD patients without RBD. The pooled meta-analysis revealed that PD patients with RBD showed a significant reduction of GM volume in the right superior temporal gyrus (STG) compared with those without RBD. This result was confirmed to be robust by the jackknife sensitivity analysis. Conclusion: Our finding shows significantly and robustly reduced GM volume in the right STG in PD patients with RBD, preliminarily suggesting the association of GM atrophy in this brain region with the occurrence of RBD in PD patients.
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Affiliation(s)
- Chengxian Yang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianbo Chang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohang Liang
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Xinjie Bao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Puligheddu M, Figorilli M, Serra A, Laccu I, Congiu P, Tamburrino L, de Natale ER, Ginatempo F, Deriu F, Loi G, Fantini ML, Schenck CH, Ferri R. REM Sleep without atonia correlates with abnormal vestibular-evoked myogenic potentials in isolated REM sleep behavior disorder. Sleep 2020; 42:5532726. [PMID: 31310647 DOI: 10.1093/sleep/zsz128] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/14/2019] [Indexed: 01/09/2023] Open
Abstract
STUDY OBJECTIVES The neurophysiological hallmark of REM sleep behavior disorder (RBD) is loss of atonia during REM sleep. Indeed, signs and symptoms of neurodegeneration can occur after years, even decades, from its beginning. This study aimed to measure neurophysiological alterations of the brainstem that potentially correlate with the severity of atonia loss, and determining whether a prodromal neurodegenerative disorder underlines this condition when it occurs as an isolated condition (iRBD). METHODS Subjects with iRBD and matched healthy controls were recruited. The study included the recording of one-night polysomnography, vestibular-evoked myogenic potentials (VEMPs), and a [123I]-FP-CIT dopamine transporter (DAT) scan. The quantification of REM sleep without atonia (RSWA) was made according to two previously published manual methods and one automated method. RESULTS The rate of alteration of VEMPs and VEMP score were significantly higher in iRBD patients than controls. Moreover, VEMP score was negatively correlated with the automated REM atonia index; a marginal statistical significance was also reached for the positive correlation with the visual tonic electromyographic parameter, while the other correlations, including that with DAT-scan score were not statistically significant. CONCLUSIONS Brainstem neurophysiology in iRBD can be assessed by VEMPs and their alterations may possibly indicate an early expression of the neurodegenerative process underlying this disorder at the brainstem level, which awaits future longitudinal confirmation. The correlation between RSWA and VEMP alteration might also represent a prodromal aspect anticipating the possible evolution from iRBD to neurodegeneration, whereas DAT-scan abnormalities might represent a later step in this evolution.
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Affiliation(s)
- Monica Puligheddu
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Michela Figorilli
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Serra
- Nuclear Medicine Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Ilaria Laccu
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Patrizia Congiu
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Ludovica Tamburrino
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Gianluigi Loi
- Nuclear Medicine Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Livia Fantini
- EEG and Sleep Unit, Neurology Department, CHU Clermont Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center and Departments of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
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Chen M, Li Y, Chen J, Gao L, Sun J, Gu Z, Wu T, Chan P. Structural and functional brain alterations in patients with idiopathic rapid eye movement sleep behavior disorder. J Neuroradiol 2020; 49:66-72. [DOI: 10.1016/j.neurad.2020.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/09/2019] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
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Lee YH, Chung SJ, Yoo HS, Lee Y, Sohn YH, Cha J, Lee PH. Gender-specific effect of urate on white matter integrity in Parkinson's disease. Parkinsonism Relat Disord 2020; 75:41-47. [PMID: 32474403 DOI: 10.1016/j.parkreldis.2020.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/25/2020] [Accepted: 05/08/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate the potential protective influence of serum uric acid (UA) level on white matter (WM) microstructural changes in de novo Parkinson's disease (PD). METHODS We enrolled a total of 184 patients with drug-naïve de novo PD and 59 age and gender-matched controls that underwent diffusion tensor imaging (DTI). Based on the distribution, serum UA levels were stratified into tertiles in PD patients by gender. Using tract-based spatial statistics (TBSS) analysis, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were used to compare WM integrity between the groups. RESULTS Interaction analysis showed that interaction effect on FA values between gender and UA levels in PD was significant in widespread WM areas, including frontal-parieto-temporal, corpus callosum, bilateral internal and external capsule, and thalamic regions. Multiple regression analysis revealed that FA values had a significantly positive correlation with UA levels across widespread WM areas in male patients. However, there was no significant correlation between DTI measures and UA levels in female patients. In a group comparison in male patients, PD with the lowest UA level (PD-L-UA) group showed significantly lower FA and higher MD and RD values in frontal-parieto-temporal WM regions than PD with the highest UA level (PD-H-UA) group. However, female patients did not show significant difference of DTI measures between PD-L-UA and PD-H-UA groups. CONCLUSIONS The present study demonstrated that the serum UA levels may have the potentially gender-specific close relationship with WM integrity in the early stage of PD.
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Affiliation(s)
- Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Yoonju Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jungho Cha
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA; Nash Family Center for Advanced Circuit Therapeutics, Ichan School of Medicine at Mount Sinai, New York, NY, USA.
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Zhang F, Niu L, Liu X, Liu Y, Li S, Yu H, Le W. Rapid Eye Movement Sleep Behavior Disorder and Neurodegenerative Diseases: An Update. Aging Dis 2020; 11:315-326. [PMID: 32257544 PMCID: PMC7069464 DOI: 10.14336/ad.2019.0324] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 03/20/2019] [Indexed: 12/11/2022] Open
Abstract
Rapid eye movement sleep behavior disorder (RBD) is a sleep behavior disorder characterized by abnormal behaviors and loss of muscle atonia during rapid eye movement (REM) sleep. RBD is generally considered to be associated with synucleinopathies, such as Parkinson’s disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA), and usually precedes years before the first symptom of these diseases. It is believed that RBD predicts the neurodegeneration in synucleinopathy. However, increasing evidences have shown that RBD is also found in non-synucleinopathy neurodegenerative diseases, including Alzheimer’s disease (AD), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), etc. Sleep disturbance such as RBD may be an early sign of neurodegeneration in these diseases, and also serve as an assessment of cognitive impairments. In this review, we updated the clinical characteristics, diagnosis, and possible mechanisms of RBD in neurogenerative diseases. A better understanding of RBD in these neurogenerative diseases will provide biomarkers and novel therapeutics for the early diagnosis and treatment of the diseases.
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Affiliation(s)
- Feng Zhang
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Long Niu
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Xinyao Liu
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Yufei Liu
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Song Li
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Huan Yu
- 3Sleep and Wake Disorders Center and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weidong Le
- 1Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China.,2Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
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Kamps S, van den Heuvel OA, van der Werf YD, Berendse HW, Weintraub D, Vriend C. Smaller subcortical volume in Parkinson patients with rapid eye movement sleep behavior disorder. Brain Imaging Behav 2020; 13:1352-1360. [PMID: 30155787 PMCID: PMC6395547 DOI: 10.1007/s11682-018-9939-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Parkinson disease (PD) patients with rapid eye movement (REM) sleep behavior disorder (RBD) have worse motor symptoms and non-motor symptoms than patients without RBD. The aim of this study was to examine underlying differences in brain structure from a network perspective. Baseline data were obtained from Parkinson's Progression Markers Initiative (PPMI) participants. We divided PD patients and healthy controls (HC) into RBD positive and RBD negative using a cutoff score of ≥5 on the RBD screening questionnaire. HC with probable RBD were excluded. We first carried out a region-of-interest analysis of structural MRIs using voxel-based morphometry to study volumetric differences for the putamen, thalamus and hippocampus in a cross-sectional design. Additionally, an exploratory whole-brain analysis was performed. To study group differences from a network perspective, we then performed a 'seed-based' analysis of structural covariance, using the bilateral dorsal-caudal putamen, mediodorsal thalamus and anterior hippocampus as seed regions. The volume of the right putamen was smaller in PD patients with RBD. RBD symptom severity correlated negatively with volume of the right putamen, left hippocampus and left thalamus. We did not find any differences in structural covariance between PD patients with and without RBD. Presence of RBD and severity of RBD symptoms in PD are associated with smaller volumes of the putamen, thalamus and hippocampus.
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Affiliation(s)
- Sanne Kamps
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk W Berendse
- Department of Neurology, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Chris Vriend
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Anatomy and Neurosciences, Amsterdam UMC, VU University Medical Center, De Boelelaan 1108, P.O. Box 705, 1007 MB, Amsterdam, The Netherlands.
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Campabadal A, Abos A, Segura B, Serradell M, Uribe C, Baggio HC, Gaig C, Santamaria J, Compta Y, Bargallo N, Junque C, Iranzo A. Disruption of posterior brain functional connectivity and its relation to cognitive impairment in idiopathic REM sleep behavior disorder. NEUROIMAGE-CLINICAL 2019; 25:102138. [PMID: 31911344 PMCID: PMC6948254 DOI: 10.1016/j.nicl.2019.102138] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/12/2022]
Abstract
There is a reduced brain posterior functional connectivity in IRBD patients. Reduced temporo-parietal connectivity correlates with mental processing slowness. Left superior parietal lobule has reduced centrality in IRBD patients.
Background Resting-state functional MRI has been proposed as a new biomarker of prodromal neurodegenerative disorders, but it has been poorly investigated in the idiopathic form of rapid-eye-movement sleep behavior disorder (IRBD), a clinical harbinger of subsequent synucleinopathy. Particularly, a complex-network approach has not been tested to study brain functional connectivity in IRBD patients. Objectives The aim of the current work is to characterize resting-state functional connectivity in IRBD patients using a complex-network approach and to determine its possible relation to cognitive impairment. Method Twenty patients with IRBD and 27 matched healthy controls (HC) underwent resting-state functional MRI with a 3T scanner and a comprehensive neuropsychological battery. The functional connectome was studied using threshold-free network-based statistics. Global and local network parameters were calculated based on graph theory and compared between groups. Head motion, age and sex were introduced as covariates in all analyses. Results IRBD patients showed reduced cortico-cortical functional connectivity strength in comparison with HC in edges located in posterior regions (p <0.05, FWE corrected). This regional pattern was also shown in an independent analysis comprising posterior areas where a decreased connectivity in 51 edges was found, whereas no significant results were detected when an anterior network was considered (p <0.05, FWE corrected). In the posterior network, the left superior parietal lobule had reduced centrality in IRBD. Functional connectivity strength between left inferior temporal lobe and right superior parietal lobule positively correlated with mental processing speed in IRBD (r = .633; p = .003). No significant correlations were found in the HC group. Conclusion : Our findings support the presence of disrupted posterior functional brain connectivity of IRBD patients similar to that found in synucleinopathies. Moreover, connectivity reductions in IRBD were associated with lower performance in mental processing speed domain.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain
| | - M Serradell
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - C Gaig
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - J Santamaria
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Y Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Parkinson's disease & Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain..
| | - A Iranzo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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Dijkstra F, Van den Bossche K, de Bruyn B, Reyn N, Viaene M, De Volder I, Cras P, Crosiers D. REM sleep without atonia and the relation with Lewy body disease. Parkinsonism Relat Disord 2019; 67:90-98. [DOI: 10.1016/j.parkreldis.2019.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/13/2019] [Accepted: 07/06/2019] [Indexed: 11/30/2022]
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Ohlhauser L, Smart CM, Gawryluk JR. Tract-Based Spatial Statistics Reveal Lower White Matter Integrity Specific to Idiopathic Rapid Eye Movement Sleep Behavior Disorder as a Proxy for Prodromal Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2019; 9:723-731. [PMID: 31498130 DOI: 10.3233/jpd-191688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by distinct motor symptoms which do not manifest until significant neurodegeneration has already occurred. Therefore, preventative treatments depend on PD being detected in a prodromal phase. To date, prodromal PD (pPD) has been conceptualized based on conditions such as REM Sleep Behavior Disorder (RBD), which has a high conversion rate to clinical PD (cPD). However, few studies have examined microstructural differences between healthy controls (HC), pPD, and cPD. OBJECTIVE The current study examined white matter microstructure in different phases of PD progression. METHODS Participants included 21 HC, 20 pPD (14 with RBD and 6 with hyposmia), and 17 cPD from the Parkinson's Progression Markers Initiative database. Tract-based spatial statistics were used to determine between group differences in fractional anisotropy (FA) and mean diffusivity (MD). RESULTS Mean diffusivity was significantly increased in pPD relative to cPD in widespread, but mostly right lateralized regions. Post-hoc analyses indicated that this pattern was particular to individuals with RBD. There were no microstructural differences between HC and pPD or cPD. The pPD group had significantly higher RBD symptoms and the cPD group had significantly higher motor symptoms. CONCLUSIONS Observed microstructural deterioration in individuals with RBD relative to cPD may indicate an altered pattern of neurodegeneration associated with RBD as a prodromal symptom of PD. Future studies should aim to further characterize possible differential patterns of progression from various non-motor symptoms (e.g., RBD, hyposmia) to cPD using longitudinal designs.
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Affiliation(s)
- Lisa Ohlhauser
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada.,Student Affiliate, Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Colette M Smart
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada.,Research Affiliate, Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Jodie R Gawryluk
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada.,Research Affiliate, Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
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Melpignano A, Parrino L, Santamaria J, Gaig C, Trippi I, Serradell M, Mutti C, Riccò M, Iranzo A. Isolated rapid eye movement sleep behavior disorder and cyclic alternating pattern: is sleep microstructure a predictive parameter of neurodegeneration? Sleep 2019; 42:5536257. [DOI: 10.1093/sleep/zsz142] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/13/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Objective
To evaluate the role of sleep cyclic alternating pattern (CAP) in patients with isolated REM sleep behavior disorder (IRBD) and ascertain whether CAP metrics might represent a marker of phenoconversion to a defined neurodegenerative condition.
Methods
Sixty-seven IRBD patients were included and classified into patients who phenoconverted to a neurodegenerative disease (RBD converters: converter REM sleep behavior disorder [cRBD]; n = 34) and remained disease-free (RBD non-converters: non-converter REM sleep behavior disorder [ncRBD]; n = 33) having a similar follow-up duration. Fourteen age- and gender-balanced healthy controls were included for comparisons.
Results
Compared to controls, CAP rate and CAP index were significantly decreased in IRBD mainly due to a decrease of A1 phase subtypes (A1 index) despite an increase in duration of both CAP A and B phases. The cRBD group had significantly lower values of CAP rate and CAP index when compared with the ncRBD group and controls. A1 index was significantly reduced in both ncRBD and cRBD groups compared to controls. When compared to the ncRBD group, A3 index was significantly decreased in the cRBD group. The Kaplan-Meier curve applied to cRBD estimated that a value of CAP rate below 32.9% was related to an average risk of conversion of 9.2 years after baseline polysomnography.
Conclusion
IRBD is not exclusively a rapid eye movement (REM) sleep parasomnia, as non-rapid eye movement (non-REM) sleep microstructure can also be affected by CAP changes. Further studies are necessary to confirm that a reduction of specific CAP metrics is a marker of neurodegeneration in IRBD.
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Affiliation(s)
- Andrea Melpignano
- Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Liborio Parrino
- Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Joan Santamaria
- Neurology Service, Multidisciplinary Sleep Unit, Universitat de Barcelona, IDIBAPS, CIBERNED, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Carles Gaig
- Neurology Service, Multidisciplinary Sleep Unit, Universitat de Barcelona, IDIBAPS, CIBERNED, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Irene Trippi
- Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Monica Serradell
- Neurology Service, Multidisciplinary Sleep Unit, Universitat de Barcelona, IDIBAPS, CIBERNED, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Carlotta Mutti
- Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo Riccò
- AUSL-IRCCS di Reggio Emilia-Department of Public Health; Service for Occupational Health and Safety on the Workplaces, Parma, Italy
| | - Alex Iranzo
- Neurology Service, Multidisciplinary Sleep Unit, Universitat de Barcelona, IDIBAPS, CIBERNED, Hospital Clinic de Barcelona, Barcelona, Spain
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Mantri S, Morley JF, Siderowf AD. The importance of preclinical diagnostics in Parkinson disease. Parkinsonism Relat Disord 2019; 64:20-28. [DOI: 10.1016/j.parkreldis.2018.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/02/2018] [Accepted: 09/08/2018] [Indexed: 01/21/2023]
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