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Parkinsons Dis. 2011;2011:941268. doi: 10.4061/2011/941268. Epub 2011 Apr 17.

Idiopathic REM Sleep Behavior Disorder: Implications for the Pathogenesis of Lewy Body Diseases.

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1
Department of Neurology, Center of Sleep Medicine, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.

Abstract

OBJECTIVES:

Both results of the odor identification and cardiac (123)I-metaiodobenzylguanidine accumulation have been investigated for their potential to enhance the detection of pathogenesis resembling that of Lewy body-related α-synucleinopathies in patients clinically diagnosed as having idiopathic REM sleep behavior disorder.

METHODS:

We performed both the Odor Stick Identification Test for Japanese and (123)I-metaiodobenzylguanidine scintigraphy in 30 patients with idiopathic REM sleep behavior disorder, 38 patients with Parkinson's disease, and 20 control subjects.

RESULTS:

In idiopathic REM sleep behavior disorder, reduced odor identification score and an early or delayed heart to mediastinum ratio on (123)I-metaiodobenzylguanidine were almost as severe as in Parkinson's disease patients. Delayed cardiac (123)I-metaiodobenzylguanidine uptake was even more severe in the idiopathic REM sleep behavior disorder group than in the Parkinson's disease group.

CONCLUSIONS:

Reduced cardiac (123)I-metaiodobenzylguanidine uptake, which is independent of parkinsonism, may be more closely associated with idiopathic REM sleep behavior disorder than olfactory impairment.

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