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Altered resting-state thalamo-occipital functional connectivity is associated with cognition in isolated rapid eye movement sleep behavior disorder
Institution:1. Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea;2. Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea;3. Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea;4. BK21 Plus Global Translational Research on Molecular Medicine and Biopharmaceutical Sciences, Seoul, South Korea;5. Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea;6. Department of Neurology, CHA University, CHA Bundang Medical Center, Seongnam, South Korea;7. Rare Disease Center, Seoul National University Hospital, Seoul, South Korea;8. Dementia Research Center, Seoul National University, Seoul, South Korea;9. Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea;10. Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN
Abstract:ObjectiveIsolated rapid eye movement sleep behavior disorder (iRBD) patients are at risk of cognitive impairments, however the underlying mechanism is still unclear. This study aimed to evaluate thalamo-cortical functional connectivity (FC) using resting-state functional magnetic resonance imaging (fMRI) and its correlation with cognitive dysfunction in patients with iRBD.MethodsA total 37 polysomnographies (PSGs) confirmed iRBD patients and 15 age-sex matched controls underwent resting-state fMRI and comprehensive neuropsychological assessment. Thalamo-cortical FC was evaluated by using seed-to voxel analysis and was compared between the iRBD and controls. Correlation between the average value of significant clusters and cognitive function scores in iRBD were calculated.ResultsCompared to the control subjects, patients with iRBD patients showed cognitive decline in word list recognition (p = 0.016), and constructional recall (p = 0.044). The FC analysis showed increased FC between the left thalamus and occipital regions including the right cuneal cortex, left fusiform gyrus and lingual gyrus (cluster level p < 0.05, corrected for false discovery rate). The averaged thalamo-fusiform FC value positively correlated with word list recognition after adjusting for age and sex (adjusted r = 0.347, p = 0.041).ConclusionThalamic resting state FC is altered in iRBD patients and is associated with the cognitive function. Enhancement of the thalamo-occipital FC may reflect a compensatory mechanism for cognitive impairment in iRBD.
Keywords:REM sleep behavior disorder  Functional brain imaging  Neuroimaging  Cognitive function
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