Abstract
Objective: In this study we investigate cortical and subcortical gray matter structure in patients with Idiopathic REM-sleep behavior disorder (IRBD), and their relation to cognitive performance.Methods: This study includes a sample of 20 patients with polysomnography-confirmed IRBD and 27 healthy controls that underwent neuropsychological and T1-weighted MRI assessment. FreeSurfer was used to estimate cortical thickness, subcortical volumetry (version 5.1), and hippocampal subfields segmentation (version 6.0). FIRST, FSL's model-based segmentation/registration tool was used for hippocampal shape analysis.Results: Compared with healthy subjects, IRBD patients showed impairment in facial recognition, verbal memory, processing speed, attention, and verbal naming. IRBD patients had cortical thinning in left superior parietal, post-central, and fusiform regions, as well as in right superior frontal and lateral occipital regions. Volumetric and shape analyses found right hippocampal atrophy in IRBD, specifically in posterior regions. Hippocampal subfields exploratory analysis identified significant differences in the right CA1, molecular layer, granule cell layer of dentate gyrus, and CA4 of this patients. No correlations were found between cognitive performance and brain atrophy.Conclusion: This work confirms the presence of posterior based cognitive dysfunction, as well as cortical and right hippocampal atrophy in IRBD patients.
Highlights
In this study we investigate cortical and subcortical gray matter structure in patients with Idiopathic Rapid eye movement (REM)-sleep behavior disorder (IRBD), and their relation to cognitive performance
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by abnormal motor and vocal behaviors associated with unpleasant dreams and increased electromyographic activity during REM sleep [1]
The risk for idiopathic form of RBD (IRBD) patients of eventually developing a neurodegenerative disease increases with time [3, 5]
Summary
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by abnormal motor and vocal behaviors associated with unpleasant dreams and increased electromyographic activity during REM sleep [1]. The idiopathic form of RBD (IRBD) has been increasingly recognized as a prodromal phase of some neurodegenerative diseases, mainly of alpha-synucleinopathies such as dementia with Lewy bodies (DLB), Parkinson’s disease (PD), and multiple system atrophy [3, 4]. The risk for IRBD patients of eventually developing a neurodegenerative disease increases with time [3, 5]. IRBD is by far the strongest and most specific clinical predictor of neurodegenerative disease available [6]. There is growing interest in describing neuroimaging and cognitive biomarkers of brain neurodegeneration in this prodromal disorder
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