Abstract
Background: Gray matter (GM) alterations in Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) have been demonstrated in many neuroimaging studies using voxel-based morphometry (VBM). However, the inconsistent findings between studies cannot be applied to clinical practice as a neuroimaging biomarker. We performed a meta-analysis of VBM studies at a whole-brain level to investigate GM differences between PD patients with and without RBD.Methods: A systematic search was conducted in PubMed, Embase, and Web of Science from inception to November 2019 to identify eligible VBM studies. We adopted the latest Seed-based d Mapping with Permutation of Subject Images technique to quantitatively estimate the difference of regional GM volume between PD patients with and without RBD.Results: We included five studies comprising 105 PD patients with RBD and 140 PD patients without RBD. The pooled meta-analysis revealed that PD patients with RBD showed a significant reduction of GM volume in the right superior temporal gyrus (STG) compared with those without RBD. This result was confirmed to be robust by the jackknife sensitivity analysis.Conclusion: Our finding shows significantly and robustly reduced GM volume in the right STG in PD patients with RBD, preliminarily suggesting the association of GM atrophy in this brain region with the occurrence of RBD in PD patients.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disorder with a rising prevalence in parallel with an aging population (Zhang et al, 2005; Pringsheim et al, 2014)
Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by loss of skeletal muscle atonia and dream-enacting behaviors associated with aggression and violence during rapid eye movement sleep (St Louis and Boeve, 2017)
We focused on regional volume changes of gray matter (GM) using voxel-based morphometry (VBM) analysis
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disorder with a rising prevalence in parallel with an aging population (Zhang et al, 2005; Pringsheim et al, 2014). Though the clinical diagnosis of PD is mainly based on cardinal motor symptoms including bradykinesia, rigidity, and rest tremor (Postuma et al, 2015), non-motor symptoms, such as hyposmia, depression, sleep disorders, and constipation, have attracted increasing attention because of their. The occurrence of RBD in PD is associated with motor function deterioration ( bradykinesia worsening) (Bugalho and Viana-Baptista, 2013), more severe non-motor symptoms (including anxiety, depression, sleep disorders, constipation, hallucination, and orthostatic hypotension) (Neikrug et al, 2014; Liu et al, 2017), poorer cognitive function (Huang et al, 2017; Jozwiak et al, 2017), and cerebral cortex abnormalities (Barber et al, 2017). Gray matter (GM) alterations in Parkinson’s disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) have been demonstrated in many neuroimaging studies using voxel-based morphometry (VBM).
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