基于18F-FDG PET显像的帕金森综合征脑代谢模式是新的诊断和鉴别诊断帕金森病(PD)的影像学标志物，但其对于PD临床前期诊断的价值尚不清楚。快动眼睡眠期行为障碍(RBD)因其向PD及帕金森叠加综合征的转归率高而成为PD临床前期研究的理想对象。我们前期的研究发现，RBD患者存在与PD相关脑代谢模式有关的异常脑代谢特征。本课题将在进一步完善基于脑代谢模式的PD诊断与鉴别诊断体系的基础上，通过前瞻性研究对特发性RBD患者进行临床评估、18F-FDG 和多巴胺转运体 PET显像及随访，利用脑代谢模式在个体水平上对RBD的转归进行基线期预测并与其临床随访的最终诊断进行比较；同时观察脑代谢模式随RBD病程进展的纵向变化特征及其与同步临床评估和多巴胺转运体显像的相关性。本研究将揭示脑代谢模式对于PD临床前期诊断与鉴别诊断、RBD亚型划分及PD临床前期病程监测的价值，为其推广应用提供依据。

Parkinsonism-related metabolic brain patterns based on 18F-FDG PET imaging are newly established biomarkers for diagnosis and diffential diagnosis of Parkinson’s disease(PD).However, their utility for diagnosing PD in the preclinical stage is unknown. Rapid-eye-movement sleep behavior disorder(RBD) is an ideal subject for studying premotor PD because of its high risk to develop neurogenerative diseases,especially PD and parkinsonism-plus syndromes. Our preliminary work demonstrated that abnormal brain glucose metabolism could be detected in some RBD patients which had a close correlation with PD-related pattern. In this study, after completing the system for PD diagnosis and diffential diagnosis based on metabolic brain patterns, a prospective research will be performed in idiopathic RBD patients by following them up with clinical assessment, 18F-FDG PET imaging and dopamine transporter PET imaging. The prognosis in individual RBD patient at baseline based on metabolic brain patterns will be compared with the final clinical diagnosis to demonstrate their value for serving as potential biomarkers for preclinical diagnosis and diffential diagnosis of PD and for classification of RBD subtypes. At the same time, longitudinal changes in the patterns with the progression of RBD and their correlations with the changes in disease severity or dopamine transporter PET imaging will be determined to demonstrate their utility for course monitoring in the preclinical stage. This study will provide evidences for metabolic brain patterns to be used more widely.