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Neurology. 2014 Feb 18;82(7):620-7. doi: 10.1212/WNL.0000000000000130. Epub 2014 Jan 22.

Abnormal metabolic network activity in REM sleep behavior disorder.

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From the Center for Neurosciences (F.H., Y.M., C.C.T., A.F., V.D., D.E.), The Feinstein Institute for Medical Research, Manhasset, NY; Center for Advanced Research in Sleep Medicine (J.-F.G., R.B.P., M.V., J.M.), Hôpital du Sacré-Coeur de Montréal; Department of Psychology (J.-F.G., M.V.), Université du Québec à Montréal; Department of Neurology (R.B.P.), Montreal General Hospital; Montreal Neurological Institute (J.-P.S.), McGill University; and Department of Psychiatry (J.M.), University of Montreal, Montréal, Canada.



To determine whether the Parkinson disease-related covariance pattern (PDRP) expression is abnormally increased in idiopathic REM sleep behavior disorder (RBD) and whether increased baseline activity is associated with greater individual risk of subsequent phenoconversion.


For this cohort study, we recruited 2 groups of RBD and control subjects. Cohort 1 comprised 10 subjects with RBD (63.5 ± 9.4 years old) and 10 healthy volunteers (62.7 ± 8.6 years old) who underwent resting-state metabolic brain imaging with (18)F-fluorodeoxyglucose PET. Cohort 2 comprised 17 subjects with RBD (68.9 ± 4.8 years old) and 17 healthy volunteers (66.6 ± 6.0 years old) who underwent resting brain perfusion imaging with ethylcysteinate dimer SPECT. The latter group was followed clinically for 4.6 ± 2.5 years by investigators blinded to the imaging results. PDRP expression was measured in both RBD groups and compared with corresponding control values.


PDRP expression was elevated in both groups of subjects with RBD (cohort 1: p < 0.04; cohort 2: p < 0.005). Of the 17 subjects with long-term follow-up, 8 were diagnosed with Parkinson disease or dementia with Lewy bodies; the others did not phenoconvert. For individual subjects with RBD, final phenoconversion status was predicted using a logistical regression model based on PDRP expression and subject age at the time of imaging (r(2) = 0.64, p < 0.0001).


Latent network abnormalities in subjects with idiopathic RBD are associated with a greater likelihood of subsequent phenoconversion to a progressive neurodegenerative syndrome.

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