Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder
Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder
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DOI：
10.1038/s41598-019-51710-y
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发表时间：
2019-10-29
影响因子：
4.6
通讯作者：
Sonka, Karel
中科院分区：
文献类型：
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作者：
Dusek, Petr;Ibarburu, Veronika Lorenzo y Losada;Sonka, Karel
本研究的目的是评估突触核蛋白病前驱期运动和非运动症状与多巴胺转运体结合的关系。我们使用运动障碍协会统一帕金森病评定量表检查了74例特发性REM睡眠行为障碍（RBD）患者和39例对照组，RBD是一种前驱突触核蛋白病（MDS-MINS）、蒙特利尔认知评估、宾夕法尼亚大学认知功能识别测试（UPSIT）、Farnsbran-Munsell 100色调测试、直立测试、PD-自主神经结局量表、Beck抑郁量表-II、状态-特质焦虑量表和视频多导睡眠图。根据因斯布鲁克-巴塞罗那睡眠标准对REM睡眠期间的肌电活动进行量化。在65例患者中，进行多巴胺转运蛋白单光子发射计算机断层扫描（DAT-SPECT）成像，计算壳核结合率，并将扫描结果分为正常、临界或异常。与对照组相比，RBD患者在所有检查测试中的评分明显更严重。DAT-SPECT异常的患者MDS-MRS运动评分较高（p = 0.006），体位性低血压的患病率较高（p = 0.008）。在REM睡眠期间，Putamina I结合率与UPSIT评分呈正相关（p =0.03），与强直性（p = 0.003）和阶段性（p = 0.01）肌肉活动呈负相关。这些关联可能反映了前驱期突触核蛋白病中黑质和易感脑干和嗅核的潜在病理学的同时进展。
The aim of this study was to evaluate associations of motor and non-motor symptoms with dopamine transporter binding in prodromal stage of synucleinopathies. We examined 74 patients with idiopathic REM sleep behavior disorder (RBD), which is a prodromal synucleinopathy, and 39 controls using Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment, University of Pennsylvania Smell Identification Test (UPSIT), Farnsworth-Munsell 100 hue test, orthostatic test, Scales for Outcomes in PD-Autonomic, Beck depression inventory-II, State-Trait Anxiety Inventory, and video-polysomnography. Electromyographic muscle activity during REM sleep was quantified according to Sleep Innsbruck-Barcelona criteria. In 65 patients, dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging was performed, putaminal binding ratio was calculated and scans were classified as normal, borderline, or abnormal. Compared to controls, RBD patients had significantly more severe scores in all examined tests. Patients with abnormal DAT-SPECT had higher MDS-UPDRS motor score (p = 0.006) and higher prevalence of orthostatic hypotension (p = 0.008). Putamina I binding ratio was positively associated with UPSIT score (p =0.03) and negatively associated with tonic (p = 0.003) and phasic (p = 0.01) muscle activity during REM sleep. These associations likely reflect simultaneous advancement of underlying pathology in substantia nigra and susceptible brainstem and olfactory nuclei in prodromal synucleinopathy.