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Parkinsonism Relat Disord. 2016 Feb;23:31-6. doi: 10.1016/j.parkreldis.2015.11.027. Epub 2015 Nov 26.

Neural substrates of rapid eye movement sleep behavior disorder in Parkinson's disease.

Author information

1
Department of Neurology, Seoul National University Boramae Hospital, Seoul, Republic of Korea; College of Medicine, Seoul National University, Seoul, Republic of Korea.
2
Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea.
3
Department of Neurology, Seoul National University Boramae Hospital, Seoul, Republic of Korea; College of Medicine, Seoul National University, Seoul, Republic of Korea. Electronic address: wieber04@snu.ac.kr.
4
Department of Psychiatry and Behavioral Science, Seoul National University Boramae Hospital, Seoul, Republic of Korea; College of Medicine, Seoul National University, Seoul, Republic of Korea.
5
Department of Nuclear Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea; College of Medicine, Seoul National University, Seoul, Republic of Korea. Electronic address: yk3181@snu.ac.kr.

Abstract

OBJECTIVES:

To investigate neural substrates of symptomatic rapid eye movement sleep behavior disorder (RBD) in Parkinson's disease (PD) by analyzing brain changes based on both hypothesis-free and hypothesis-driven neuroimaging analyses.

METHODS:

A total of 63 subjects (14 PDRBD-, 24 PDRBD+, and 25 age-matched healthy controls = HC) were enrolled in this study. RBD was defined by RBD screening questionnaire with video-polysomnographic confirmation. All subjects underwent volumetric and diffusion tensor imaging. The whole brain gray- and white-matter changes were analyzed and the central ascending cholinergic pathway involving the pedunculopontine nucleus and thalamus was compared with a region-of-interest analysis and probabilistic tractography.

RESULTS:

The PDRBD+ group showed decreased gray matter volume of the left posterior cingulate and hippocampus compared to the PDRBD- and additional gray matter decrease in the left precuneus, cuneus, medial frontal gyrus, postcentral gyrus and both inferior parietal lobule compared to the HC group (uncorrected p < 0.001, k = 50). There were no significant differences in white matter changes between the PDRBD- and PDRBD+ groups both by fractional anisotropy and mean diffusivities. However, both PD groups showed widespread changes by fractional anisotropy reductions and mean diffusivity increments compared to HC (p < 0.05 corrected). There were no significant differences in tract-based spatial statistics and the normalized tract volumes as well as the diffusion indices of both the thalamus and pedunculopontine nuclei among the study groups.

CONCLUSIONS:

The appearance of RBD in PD may be related to regional gray matter changes in the left posterior cingulate and hippocampus but not localized to the brainstem.

KEYWORDS:

Diffusion tensor imaging; Magnetic resonance imaging; Parkinson's disease; Rapid eye movement sleep behavior disorder

[Indexed for MEDLINE]

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