P93. Ictal SPECT in patients with REM sleep behavior disorder

Abstract

Introduction Patients with idiopathic REM sleep behavior disorder (iRBD) have the same phenotype as those with Parkinson and RBD (PD + RBD) and narcolepsy and RBD (nRBD). Little is known if different types of RBD share the same pathways during their nocturnal activities. The aim of the study was to compare ictal SPECT of different types of RBD. Methods Recording was performed as 22 channel video-EEG polysomnography using an IT- Med system l. Ictal and interictal subtraction SPECT was performed after using a semiautomatic SPECT injection device permitting immediate intravenous application of the radioligand ECD with a latency or 10 epochs and complex behavior in REM sleep > 10 epochs. Ictal and interictal reconstructed datasets were subtracted pixelwise from each other, the difference images were coregistered to MRI images. Patients 2 iRBD, 2 with nRBD. 1 iRBD patient had converted to Parkinson’s disease (Hoehn & Yahr 4). Patients fulfilled RBD criteria according to the International Classification of Sleep Disorders 2 (2005). All patients gave their written consent. The study was approved by the Ethical Committee of the Chamber of Physicians of the state of Hessen/Germany. Results All patients independent of their RBD type displayed a similar pattern of activation in the ictal SPECT. The activation included the premotor areas bilaterally, the interhemispheric cleft, the periaqueductal area, the dorsal and ventral pons and the anterior part of the cerebellum. Conclusion The ictal pathway of RBD is the same in iRBD, PD + RBD and nRBD.