快动眼睡眠行为障碍(RBD)是帕金森病（PD）常见的非运动症状，是预测PD认知功能减退、病情恶化的标志之一。REM期骨骼肌失迟缓是RBD的显著特征，同时伴有噩梦及与梦境相关的暴力动作。RBD产生的机制尚不清楚，申请者认为认知控制缺陷机制在RBD的发生中起了重要的作用，RBD发作是REM期反应抑制缺陷的表现形式。在疾病、遗传易感性等因素作用下，造成大脑认知控制环路和脑干结构或功能双重受损，导致REM期特定脑区/核团异常兴奋、运动环路被激活。对认知控制环路进行调控，可望减少或增加RBD发作。本项目拟采用神经电生理，结合结构和功能成像技术研究PD伴RBD认知控制的神经机制，以期确定出决定RBD认知控制缺陷的关键核团及环路，探索遗传易感性、药物等在RBD特定认知控制网络中的作用，以期揭示RBD的病理生理机制，为RBD的认知行为治疗及药物治疗提供依据，为脑深部电刺激术和经颅磁刺激等提供治疗靶点。

The dream enactment of rapid eye movement sleep behavior disorder (RBD) is often the first indication of an impending α-synuclein disorder, such as Parkinson disease (PD), multiple-system atrophy, or dementia with Lewy bodies. Approximately 50% of patients with idiopathic RBD will convert to a parkinsonian disorder within a decade. Ultimately, nearly 81%-90% patients with RBD develop a neurodegenerative disorder..RBD is one of common non-motor symptoms of PD, as premotor symptoms for several years before motor disorder occur. The incidence of clinical RBD increased with the progression of PD. RBD in PD is a predictor of cognitive decline and deterioration of motor symptoms. The mechanism of RBD is not clear. The pathological and functional neuroimaging studies suggest that RBD is not only involved in the brainstem, but also the superior cerebral cortex. Our pilot studies suggest that the structural and functional abnormalities of top-down cognitive control loop may be the basis of RBD pathophysiology. This study intends to explore neural mechanism of cognitive control defects of PD with RBD by combinations of electrophysiological examination with structure and functional MRI, to identify the key nucleus and loop of cognitive control defects for RBD. Then, the effect of genetic susceptibility, medication on cognitive control network of RBD will be investigated in order to reveal further the pathophysiological mechanism of RBD, which will lead to provide the theoretical evidence for cognitive behavioral therapy and medication for RBD, and a new therapeutic target for deep brain stimulation and transcranial magnetic stimulation.