In-vivosignatures of neurodegeneration in isolated rapid eye movement sleep behaviour disorder
In-vivosignatures of neurodegeneration in isolated rapid eye movement sleep behaviour disorder
复制标题
DOI：
10.1111/ene.14215
复制
发表时间：
2020-07-01
影响因子：
5.1
通讯作者：
Perani, D.
中科院分区：
文献类型：
--
作者：
Carli, G.;Caminiti, S. P.;Perani, D.
背景和目的孤立性快速眼动睡眠行为障碍（iRBD）是一种睡眠异常，近年来被认为是帕金森病、路易体痴呆和多系统萎缩的危险因素。由于缺乏这种情况的证据，iRBD中的生物标志物研究是相关的。鉴定能够预测突触核蛋白病疾病进展的生物标志物对于iRBD至关重要。氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）成像可能提供有关正在进行的神经退行性过程的信息。在本研究中，我们测试了单个iRBD个体中是否存在作为神经退行性疾病生物标志物的大脑代谢低下模式。方法收集37例经多导睡眠图证实的iRBD患者，进行神经心理学评估和FDG-PET扫描。使用经验证的统计参数映射程序分析图像，提供个体代谢减退图。结果22例iRBD患者认知功能正常，15例患者存在视觉感知/视觉空间和记忆功能障碍。五角大楼测试定性评分有五分之一的病例受损。在32例iRBD病例中，FDG-PET统计参数图显示了显著的脑代谢低下，即枕叶（n = 5）、枕和小脑区（n = 13）、枕顶区（n = 13）和选择性小脑代谢低下（n = 1）。5例FDG-PET扫描正常。结论这些影像学结果表明，脑神经退行性病变的存在，并已在iRBD检测。单个个体中不同的低代谢模式可能反映了由于潜在的突触核蛋白病导致的特定早期病理生理学事件，枕叶皮质具有特定的神经脆弱性，其可能早于路易体痴呆进展的风险。
Background and purpose Isolated rapid eye movement sleep behaviour disorder (iRBD) is a parasomnia, recently recognized as a risk factor for progression to Parkinson's disease, dementia with Lewy body and multiple system atrophy. Biomarker studies in iRBD are relevant due to lack of evidence in this condition. The identification of biomarkers able to predict progression to synucleinopathy diseases is critical for iRBD. Fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging might provide information about ongoing neurodegenerative processes. In the present study, we tested for presence of brain hypometabolism patterns as biomarkers of neurodegeneration in single iRBD individuals. Methods We recruited 37 subjects with polysomnography-confirmed iRBD, with neuropsychological assessment and available FDG-PET scan. Images were analysed with a validated statistical parametric mapping procedure, providing individual hypometabolism maps. Results According to the neuropsychological evaluation, 22 subjects with iRBD had normal cognition and 15 subjects showed impairments, particularly in visuoperceptive/visuospatial and memory domains. One-fifth of the cases were impaired on the Qualitative Scoring of Pentagon Test. In 32 iRBD cases, FDG-PET statistical parametric maps revealed significant cerebral hypometabolism, namely in the occipital lobes (n = 5), occipital and cerebellar regions (n = 13), occipitoparietal regions (n = 13) and a selective cerebellar hypometabolism (n = 1). Five cases had normal FDG-PET scans. Conclusions These imaging findings indicate that brain neurodegenerative processes are present and already detectable in iRBD. The different hypometabolism patterns in the single individuals may reflect specific early pathophysiological events due to the underlying synucleinopathy, with a specific neural vulnerability for the occipital cortex that might pre-date a risk of progression towards dementia with Lewy body.