Magnetic Resonance Parkinsonism Index Is Associated with REM Sleep Behavior Disorder in Parkinson's Disease.

Daniele Urso,Benedetta Tafuri,Marco Filardi,Roberto De Blasi,K Ray Chaudhuri,Valentina Gnoni,Giancarlo Logroscino,Salvatore Nigro

doi:10.3390/brainsci12020202

Abstract

We investigated the association between the Magnetic Resonance Parkinsonism Index (MRPI) and REM sleep behavior disorder (RBD). We included 226 de novo PD patients (82 PD-RBD and 144 PD-noRBD) and 19 idiopathic RBD patients. Furthermore, 3T T1-weighted MR images were used for automated brainstem calculations. MRPI values were higher in the PD-RBD (p = 0.004) compared to PD-noRBD patients. Moreover, MRPI proved to be a significant predictor of REM Behavior Disorder Screening Questionnaire scores in PD (β = 0.195, p = 0.007) and iRBD patients (β = 0.582, p = 0.003). MRPI can be used as an imaging marker of RBD in patients with de novo PD and iRBD.

Highlights

REM sleep behavior disorder (RBD) is characterized by loss of physiological muscle atonia and episodes of dream-enactment behaviors during REM sleep [1]
We investigated whether the Magnetic Resonance Parkinsonism Index (MRPI) could represent a useful neuroimaging marker able to capture the morphometric changes of brainstem subregions associated with RBD in de novo patients with PD and subjects with Idiopathic RBD (iRBD)
A total of 82 PD patients were classified as PD-RBD while 144 were classified as PD-noRBD

Summary

Introduction

REM sleep behavior disorder (RBD) is characterized by loss of physiological muscle atonia and episodes of dream-enactment behaviors during REM sleep [1]. RBD’s pathophysiology has not been completely elucidated, lesions in the brainstem structures, such as midbrain, pons, and medulla,- have been associated with RBD in both animal [5,6] and human studies [7]. The Magnetic Resonance Parkinsonism Index (MRPI), which integrates the pons and midbrain areas and the width of middle and superior cerebellar peduncles, has been proven to be a measure to capture the midbrain and superior cerebellar peduncles atrophy, characterizing patients with progressive supranuclear palsy [13,14]. We investigated whether the MRPI could represent a useful neuroimaging marker able to capture the morphometric changes of brainstem subregions associated with RBD in de novo patients with PD and subjects with iRBD

Methods

Results

Conclusion