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Meles, S.K.* ; Renken, R.J.* ; Janzen, A.* ; Vadasz, D.* ; Pagani, M.* ; Arnaldi, D.* ; Morbelli, S.* ; Nobili, F.* ; Mayer, G.* ; Leenders, K.L.* ; Oertel, W.H.

The metabolic pattern of idiopathic REM sleep behavior disorder reflects early-stage Parkinson’s disease.

J. Nucl. Med. 59, 1437-1444 (2018)
Publ. Version/Full Text Postprint DOI PMC
Open Access Green
Idiopathic REM sleep behavior disorder (iRBD) is considered a prodromal stage of Parkinson disease (PD) and other Lewy body disorders. Spatial covariance analysis of F-18-FDG PET data has disclosed a specific brain pattern of altered glucose metabolism in PD. In this study, we identify the metabolic pattern underlying iRBD and compare it with the known PD pattern. To understand the relevance of the iRBD pattern to disease progression, we studied the expression of the iRBD pattern in de novo PD patients.Methods: The iRBD-related pattern was identified in F-18-FDG PET scans of 21 patients with polysomnographically confirmed iRBD and 19 controls using spatial covariance analysis. Expression of the iRBD-related pattern was subsequently computed in F-18-FDG PET scans of 44 controls and 38 de novo, treatment-naive PD patients. Of these 38 PD patients, 24 had probable REM sleep behavior disorder (RBD) according to the Mayo Sleep Questionnaire. Neuropsychologic evaluation showed mild cognitive impairment in 20 PD patients (PD-MCI), of whom 16 also had concomitant RBD and roughly half (11/20) had bilateral motor symptoms.Results: The iRBD-related pattern was characterized by relative hypermetabolism in the cerebellum, brain stem, thalamus, sensorimotor cortex, and hippocampus, and by relative hypometabolism in the middle cingulate, temporal, occipital, and parietal cortices. This topography partially overlapped with the PD-related pattern (PDRP). The iRBD-related pattern was significantly expressed in PD patients compared with controls (P < 0.0001). iRBD-related pattern expression was not significantly different between PD patients with and without probable RBD, or between PD patients with unilateral or bilateral parkinsonism. iRBD-related pattern (iRBDRP) expression was higher in PD-MCI patients than in PD patients with preserved cognition (P 5 0.001). Subject scores on the iRBD-related pattern were highly correlated to subject scores on the PDRP (r = 0.94, P < 0.0001).Conclusion: Our results show that the iRBDRP is an early manifestation of the PDRP. Expression of both PDRP and iRBDRP was higher in patients with a more severe form of PD (PD-MCI), which indicates that expression of the 2 patterns increases with disease severity.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Neurology ; Pet/ct ; Statistical ; Analysis ; F-18-fdg-pet ; Idiopathic Rem ; Sleep Behavior Disorder ; Parkinson's Disease Related Pattern ; Alpha-synucleinopathy ; Metabolic Pattern; Drug-naive Patients; Network Activity; Neurodegenerative Disease; Pedunculopontine Nucleus; Brain Perfusion; Fdg-pet; Dementia; Motor; Hypometabolism; Abnormalities
ISSN (print) / ISBN 0161-5505
e-ISSN 1535-5667
Journal Journal of Nuclear Medicine
Quellenangaben Volume: 59, Issue: 9, Pages: 1437-1444 Article Number: , Supplement: ,
Publisher Society of Nuclear Medicine and Molecular Imaging
Publishing Place 1850 Samuel Morse Dr, Reston, Va 20190-5316 Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Neurogenomics (ING)