Characterizing the heterogeneous metabolic progression in idiopathic REM sleep behavior disorder

NeuroImage: Clinical

Igor Yakushev¹  Wolfgang Oertel²  Chuantao Zuo³  Axel Rominger⁴  Stefan Förster⁵  Guenter Höglinger⁶  Huan Yu⁶  Panagiotis Bargiotas⁷  Markus Schwaiger⁷  Sung-Cheng Huang⁸  Jian Wang⁹  Claudio Bassetti⁹  Kuangyu Shi^1,10  Jiehui Jiang^1,10  Ian Alberts^1,10  Hucheng Zhou^1,11  Paul Cumming^1,12  Xianhua Han^1,13  Ping Wu^1,13 

[1] Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus;Department of Nuclear Medicine, Klinikum Bayreuth, Germany;School of Psychology and Counselling and IHBI, Queensland University of Technology, Brisbane, Australia;Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, USA;Department of Neurology, Hannover Medical School, Germany;Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China;Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland;Department of Neurology, University of Marburg, Germany;Department of Nuclear Medicine, Technische Universität München, Munich, Germany;Department of Nuclear Medicine, University of Bern, Switzerland;Key Laboratory of Specialty Fiber Optics and Optical Access Networks, Joint International Research Laboratory of Specialty Fiber Optics and Advanced Communication ,Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China;Klinikum r. d. Isar, Technische Universität München, Munich, Germany;PET Center, Huashan Hospital, Fudan University, Shanghai, China;

关键词: REM sleep behavior disorder;    Parkinson’s disease;    PET;    FDG;    Conversion;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is a prodromal stage of synucleinopathies such as Parkinson’s disease (PD). Positron emission tomography (PET) with 18F-FDG reveals metabolic perturbations, which are scored by spatial covariance analysis. However, the resultant pattern scores do not capture the spatially heterogeneous trajectories of metabolic changes between individual brain regions. Assuming metabolic progression occurs as a continuum from the healthy control (HC) condition to iRBD and then PD, we investigated spatial dynamics of progressively perturbed glucose metabolism in a cross-sectional study. Methods: 19 iRBD patients, 38 PD patients and 19 HC subjects underwent 18F-FDG PET. The images were spatially normalized, scaled to the global mean uptake, and automatically parcellated. We contrasted regional metabolism by group, and allocated the inferred progression to one of several possible trajectories. We further investigated the correlations between 18F-FDG uptake and the disease duration in the iRBD and PD groups, respectively. We also explored relationships between 18F-FDG uptake and the Unified Parkinson’s Disease Rating Scale motor (UPDRS III) scores in the PD group. Results: PD patients exhibited more extensive relative hyper- and hypo-metabolism than iRBD patients. We identified three dynamic metabolic trajectories, cross-sectional hypo- or hypermetabolism, cross-sectionally unchanged hypo- or hypermetabolism, cross-sectionally late hypo- or hypermetabolism, appearing only in the contrast of PD with iRBD. No correlation was found between relative 18F-FDG metabolism and disease duration in the iRBD group. Regional hyper- and hypo-metabolism in the PD patients correlated with disease duration or clinical UPDRS III scores. Conclusion: Cerebral metabolism changes heterogeneously in a continuum extending from HC to iRBD and PD groups in this preliminary study. The distinctive metabolic trajectories point towards a potential neuroimaging biomarker for conversion of iRBD to frank PD, which should be amenable to advanced pattern recognition analysis in future longitudinal studies.

【 授权许可】

Unknown