Idiopathic rapid eye movement sleep behavior disorder in Japan: An observational study
Idiopathic rapid eye movement sleep behavior disorder in Japan: An observational study
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日本特发性快速动眼睡眠行为障碍：一项观察性研究
DOI：
10.1016/j.parkreldis.2022.08.011
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Watanabe H
中科院分区：
文献类型：
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作者：
Nishikawa N;Murata M;Hatano T;Mukai Y;Saitoh Y;Sakamoto T;Hanakawa T;Kamei Y;Tachimori H;Hatano K;Matsuda H;Taruno Y;Sawamoto N;Kajiyama Y;Ikenaka K;Kawabata K;Nakamura T;Iwaki H;Kadotani H;Sumi Y;Inoue Y;Hayashi T;Ikeuchi T;Shimo Y;Mochizuki H;Watanabe H
特发性快速眼动睡眠行为障碍（idiopathic rapid eye movement sleep behavior disorder，iRBD）是包括帕金森病（Parkinson's disease，PD）和多系统萎缩在内的突触核蛋白病（synucleinopathy，synucleinopathy）的最特异的前驱症状之一。日本帕金森病进展标志物计划（J-PPMI）是一项在日本iRBD患者中进行的前瞻性队列研究，旨在研究前驱期突触核蛋白病的生物标志物。我们进行了初步评估的J-PPMI研究，以揭示与多巴胺转运蛋白单光子发射计算机断层扫描（DaT）and123 I-间碘苄胍（MIBG）心肌acuptigraphy.MethodsThis横断面研究进行了108例iRBD，从J-PPMI研究选择的因素。我们根据MIBG和DaT结果将患者分为四组。我们还记录了患者的人口统计学和临床数据。PD概率计算后，我们研究了与DaT和MIBG.Results95（88%）的入组患者符合前驱PD的诊断标准的基础上的概率得分的生物标志物。仅5例患者MIBG和DaT正常，我们确定了29例DaT和MIBG降低的患者，均符合上述诊断标准。DaT和MIBG与日本版的蒙特利尔认知评估（MoCA-J）score.ConclusionBoth DaT和MIBG是重要的生物标志物，用于确认synucleinopathies和/或分期疾病进展。虽然95%的iRBD患者与身体优先亚型概念一致，但iRBD的α-突触核蛋白病理可能具有广泛的全身性受累，而不是局限于下脑干，特别是在MoCA-J评分降低的患者中。
IntroductionIdiopathic rapid eye movement sleep behavior disorder (iRBD) is one of the most specific prodromal symptoms of synucleinopathies, including Parkinson's disease (PD) and multiple system atrophy. The Japan Parkinson's Progression Markers Initiative (J-PPMI) was a prospective cohort study conducted in Japanese patients with iRBD to investigate biomarkers for prodromal synucleinopathies. We carried out an initial assessment of the J-PPMI study to reveal the factors correlated with dopamine transporter single-photon emission computed tomography (DaT) and123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy.MethodsThis cross-sectional study was conducted in 108 patients with iRBD, selected from the J-PPMI study. We divided the patients into four groups based on the MIBG and DaT results. We also recorded the patients’ demographics and clinical data. Following PD probability calculation, we examined the biomarkers associated with DaT and MIBG.ResultsNinety-five of the enrolled patients (88%) met the diagnostic criteria for prodromal PD based on the probability score. Only five patients had normal MIBG and DaT. We identified 29 cases with decreased DaT and MIBG, all of whom met the above diagnostic criteria. Both DaT and MIBG were significantly correlated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) score.ConclusionBoth DaT and MIBG are important biomarkers for confirming synucleinopathies and/or staging disease progression. Although 95% of iRBD patients were consistent with the body-first subtype concept, alpha-synuclein pathologies of iRBD might have widespread systemic involvement rather than being confined to the lower brainstem, particularly in patients with reduced MoCA-J scores.