npj Parkinsons Dis: Rapid eye movement behavior associated with Parkinson's cortical thinning

Rapid eye movement (REM) sleep behavior disorder (RBD), a parasitic insomnia characterized by vivid dreams associated with simple or complex motor behaviors during REM sleep, is the most common non-specific disorder of Parkinson's disease (PD).

Rapid eye movement (REM) sleep behavior disorder (RBD), a parasitic insomnia characterized by vivid dreams associated with simple or complex motor behaviors during REM sleep, is the most common non-specific disorder of Parkinson's disease (PD).

Figure 1 Title map of the paper

Figure 1 Title map of the paper

Furthermore, RBD occurs in up to 25% of new-onset PD patients, and the prevalence increases with disease progression

Furthermore, RBD occurs in up to 25% of new-onset PD patients, and the prevalence increases with disease progression

Meanwhile, the presence of RBD in PD was associated with faster motor progression, future development of hallucinations, autonomic dysfunction, and impaired color vision

Based on animal studies, RBD is thought to be associated with dysfunction of the brainstem nuclei network

However, studies using diffusion tensor imaging found no differences in brainstem structure in PD patients with RBD compared to patients without RBD

Despite previous studies suggesting the importance of RBD as a prognostic factor for the rapid progression of motor and non-motor symptoms in PD, and a possible mechanism for RBD beyond brainstem structures in PD patients, little is known about RBD-related brain changes in PD

As a sensitive marker of gray matter atrophy, cortical thinning is associated with idiopathic RBD, PD with RBD, and the risk of conversion to Lewy body disorder in patients with idiopathic RBD

Hereby, Eun Jin Yoon et al.

The core hypothesis is that PD patients with RBD will show more cross-sectional and longitudinal brain atrophy than patients without RBD, and these changes will be related to their motor and non-motor symptoms

They studied 78 participants from the Parkinson's Disease Progression Markers Initiative (PPMI)

They compared cross-sectional and longitudinal changes in cortical thickness and subcortical volume between PD patients with and without pRBD

At baseline, bilateral infratemporal cortex thinned in the PD-pRBD group

Figure 2 Differences in cortical thickness between the two groups

Figure 2 Differences in cortical thickness between the two groups

The bilateral infratemporal cortex was thinned in the PD-pRBD group compared with the PD-noRBD group

The bilateral infratemporal cortex was thinned in the PD-pRBD group compared with the PD-noRBD group

Longitudinal, the thinning rate of the left insula was significantly increased in the PD-pRBD group compared with the PD-noRBD group
.

The rate of thinning of the left insula was significantly increased compared with the PD-noRBD group, and the increased thinning was associated with a decline in cognitive performance
.

The rate of thinning of the left insula was significantly increased compared with the PD-noRBD group, and the increased thinning was associated with a decline in cognitive performance
.

In subcortical volume analysis, the presence of pRBD was associated with a decrease in the volume of the left caudate nucleus and globus pallidus over time
.
Left caudate nucleus, globus pallidus, and amygdala
.
Volumetric changes in the left caudate nucleus show associations with global cognition
.

In subcortical volume analysis, the presence of pRBD was associated with a decrease in the volume of the left caudate nucleus and globus pallidus over time
.
Left caudate nucleus, globus pallidus, and amygdala
.
Volumetric changes in the left caudate nucleus show associations with global cognition
.

These results support that RBD is a rapid development of motor and non-motor symptoms in PD , and suggest that atrophy of the left insula and caudate nucleus may be the underlying neurobiological mechanism underlying the poor prognosis of PD patients
.
Neurobiological mechanisms underlying poor prognosis
.

These results support that RBD is a rapid development of motor and non-motor symptoms in PD , and suggest that atrophy of the left insula and caudate nucleus may be the underlying neurobiological mechanism underlying the poor prognosis of PD patients
.
Neurobiological mechanisms underlying poor prognosis
.
RBD is PD with rapid progression of motor and non-motor symptoms

Source:
Yoon EJ, Monchi O.
Probable REM sleep behavior disorder is associated with longitudinal cortical thinning in Parkinson's disease.
npj Parkinsons Dis.
2021;7(1):19.
doi:10.
1038/s41531-021-00164-z

Original source:
Yoon EJ, Monchi O.
Probable REM sleep behavior disorder is associated with longitudinal cortical thinning in Parkinson's disease.
npj Parkinsons Dis.
2021;7(1):19.
doi:10.
1038/s41531-021-00164-z Probable REM sleep behavior disorder is associated with longitudinal cortical thinning in Parkinson's disease.


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