Neural substrates of rapid eye movement sleep behavior disorder in Parkinson's disease |
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| Affiliation: | 1. Department of Neurology, Seoul National University Boramae Hospital, Seoul, Republic of Korea;2. Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea;3. Department of Nuclear Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea;4. Department of Psychiatry and Behavioral Science, Seoul National University Boramae Hospital, Seoul, Republic of Korea;5. College of Medicine, Seoul National University, Seoul, Republic of Korea;1. Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy;2. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy;3. Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands;4. Department of Neurophysiology, San Gennaro Hospital, Naples, Italy;5. Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy;1. Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea;2. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea;1. Department of Research, National Neuroscience Institute, Singapore;2. Department of Diagnostic Radiology, Singapore General Hospital, Singapore;3. Duke-NUS Graduate Medical School, Singapore;4. Department of Neurology, National Neuroscience Institute, Singapore;1. PET Center, Huashan Hospital, Fudan University, Shanghai, China;2. Department of Nuclear Medicine, Kunshan First People''s Hospital, Suzhou, China;3. Sleep and Wake Disorders Center, Huashan Hospital, Fudan University, Shanghai, China;4. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China;5. National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China;6. Human Phenome Institute, Fudan University, Shanghai, China;7. Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China |
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| Abstract: | ObjectivesTo investigate neural substrates of symptomatic rapid eye movement sleep behavior disorder (RBD) in Parkinson's disease (PD) by analyzing brain changes based on both hypothesis-free and hypothesis-driven neuroimaging analyses.MethodsA total of 63 subjects (14 PDRBD−, 24 PDRBD+, and 25 age-matched healthy controls = HC) were enrolled in this study. RBD was defined by RBD screening questionnaire with video-polysomnographic confirmation. All subjects underwent volumetric and diffusion tensor imaging. The whole brain gray- and white-matter changes were analyzed and the central ascending cholinergic pathway involving the pedunculopontine nucleus and thalamus was compared with a region-of-interest analysis and probabilistic tractography.ResultsThe PDRBD+ group showed decreased gray matter volume of the left posterior cingulate and hippocampus compared to the PDRBD− and additional gray matter decrease in the left precuneus, cuneus, medial frontal gyrus, postcentral gyrus and both inferior parietal lobule compared to the HC group (uncorrected p < 0.001, k = 50). There were no significant differences in white matter changes between the PDRBD− and PDRBD+ groups both by fractional anisotropy and mean diffusivities. However, both PD groups showed widespread changes by fractional anisotropy reductions and mean diffusivity increments compared to HC (p < 0.05 corrected). There were no significant differences in tract-based spatial statistics and the normalized tract volumes as well as the diffusion indices of both the thalamus and pedunculopontine nuclei among the study groups.ConclusionsThe appearance of RBD in PD may be related to regional gray matter changes in the left posterior cingulate and hippocampus but not localized to the brainstem. |
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| Keywords: | Rapid eye movement sleep behavior disorder Parkinson's disease Magnetic resonance imaging Diffusion tensor imaging |
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