Cholinergic Nucleus 4 Degeneration and Cognitive Impairment in Isolated Rapid Eye Movement Sleep Behavior Disorder |
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| Authors: | Christopher Tan Huma Nawaz MBBS Sarah K. Lageman PhD Leslie J. Cloud MD MSc Amy W. Amara MD PhD Benjamin T. Newman PhD T. Jason Druzgal MD PhD Brian D. Berman MD MSc Nitai Mukhopadhyay PhD Matthew J. Barrett MD MSc |
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| Affiliation: | 1. Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA;2. Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA;3. Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA;4. Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA;5. Department of Biostatistics, Virginia Commonwealth University Health, Richmond, Virginia, USA |
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| Abstract: | Background Cholinergic nucleus 4 (Ch4) degeneration is associated with cognitive impairment in Parkinson's disease and dementia with Lewy bodies, but it is unknown if Ch4 degeneration is also present in isolated rapid eye movement sleep behavior disorder (iRBD). Objective The aim was to determine if there is evidence of Ch4 degeneration in patients with iRBD and if it is associated with cognitive impairment. Methods We analyzed the clinical and neuropsychological data of 35 iRBD patients and 35 age- and sex-matched healthy controls. Regional gray matter density (GMD) was calculated for Ch4 using probabilistic maps applied to brain magnetic resonance imaging (MRI). Results Ch4 GMD was significantly lower in the iRBD group compared to controls (0.417 vs. 0.441, P = 0.02). Ch4 GMD was also found to be a significant predictor of letter number sequencing (β-coefficient = 58.31, P = 0.026, 95% confidence interval [7.47, 109.15]), a measure of working memory. Conclusions iRBD is associated with Ch4 degeneration, and Ch4 degeneration in iRBD is associated with impairment in working memory. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. |
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| Keywords: | cholinergic basal forebrain cognitive impairment rapid eye movement sleep behavior disorder working memory magnetic resonance imaging voxel-based morphometry |
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