Functional neuroimaging and clinical features of drug naive patients with de novo Parkinson’s disease and probable RBD |
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| Institution: | 1. Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy;2. Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy;3. Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy;4. Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy;1. Division of Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland;2. Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland;3. Department of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland;4. Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland;1. Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India;2. Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India;3. Department of Clinical Psychology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India;1. Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;2. Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain;3. Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain;4. Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain;5. Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;3. Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;4. Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands;5. Department of Medical Physics, Catharina Hospital, Eindhoven, The Netherlands;6. San Raffaele University and Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy;1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom;2. Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy;3. Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Italy;4. University Parthenope, Naples, Italy;5. IDC-Hermitage-Capodimonte, Naples, Italy;6. Department of Primary Care and Public Health, Imperial College London, United Kingdom;7. Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples Federico II, Naples, Italy |
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| Abstract: | IntroductionThe association between Parkinson Disease (PD) and REM sleep behavior disorder (RBD) has been related to a specific, malignant clinical phenotype. Definite RBD diagnosis requires video-polysomnography that is often unfeasible. A malignant clinical PD-RBD phenotype could be expected also in PD patients with probable RBD. Aim of this cross-sectional study was to evaluate whether a more severe neuropsychological and functional neuroimaging phenotype can be identified in PD patients with probable RBD.MethodsThirty-eight de novo, drug naïve PD patients underwent a first-line clinical assessment and a second-line multimodal assessment, including neuropsychological evaluation, 123I-FP-CIT-SPECT and 18F-FDG-PET, which were compared between PD patients with (PD + RBD+) and without (PD + RBD-) probable RBD.ResultsOn first-line assessment, PD + RBD + patients had significantly more constipation (p = 0.02) and showed worse olfaction (p = 0.01) compared with PD + RBD-while the two groups were similar as for age, presence of orthostatic hypotension, UPDRS-III and MMSE scores. On second-line assessment, PD + RBD + patients showed a worse neuropsychological test profile, more severe nigro-striatal dopaminergic impairment, mainly at caudate level in the less affected hemisphere (p = 0.004) and impaired brain glucose metabolism, with relative hypometabolism in posterior cortical regions and relative hypermetabolism mainly in anterior regions of the more affected hemisphere (p = 0.015).ConclusionsPD patients with probable RBD are likely to have a more severe neuropsychological and functional brain-imaging phenotype already at the time of diagnosis. |
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| Keywords: | PD RBD Cognitive |
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