Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, and Department of Psychology, University of Montreal, Montreal, Quebec, Canada.
Mov Disord. 2011 Aug 1;26(9):1717-24. doi: 10.1002/mds.23721. Epub 2011 May 3.
Potential early markers of neurodegeneration such as subtle motor signs, reduced color discrimination, olfactory impairment, and brain perfusion abnormalities have been reported in idiopathic rapid eye movement sleep behavior disorder, a risk factor for Parkinson's disease and Lewy body dementia. The aim of this study was to reproduce observations of regional cerebral blood flow abnormalities in a larger independent sample of patients and to explore correlations between regional cerebral blood flow and markers of neurodegeneration. Twenty patients with idiopathic rapid eye movement sleep behavior disorder and 20 healthy controls were studied by single-photon emission computerized tomography. Motor examination, color discrimination, and olfactory identification were examined. Patients with rapid eye movement sleep behavior disorder showed decreased regional cerebral blood flow in the frontal cortex and in medial parietal areas and increased regional cerebral blood flow in subcortical regions including the bilateral pons, putamen, and hippocampus. In rapid eye movement sleep behavior disorder, brain perfusion in the frontal cortex and occipital areas was associated with poorer performance in the color discrimination test. Moreover, a relationship between loss of olfactory discrimination and regional cerebral blood flow reduction in the bilateral anterior parahippocampal gyrus, a region known to be involved in olfactory functions, was found. This study provides further evidence of regional cerebral blood flow abnormalities in rapid eye movement sleep behavior disorder that are similar to those seen in Parkinson's disease and Lewy body dementia. Moreover, regional cerebral blood flow anomalies were associated with markers of neurodegeneration.
已经有报道称，在特发性快速眼动睡眠行为障碍（帕金森病和路易体痴呆的危险因素）中存在潜在的神经退行性变早期标志物，如细微的运动迹象、色觉减退、嗅觉障碍和脑灌注异常。本研究的目的是在更大的独立患者样本中重现区域性脑血流异常的观察结果，并探讨区域性脑血流与神经退行性变标志物之间的相关性。通过单光子发射计算机断层扫描对 20 例特发性快速眼动睡眠行为障碍患者和 20 例健康对照者进行研究。进行了运动检查、颜色辨别和嗅觉识别检查。快速眼动睡眠行为障碍患者的额叶皮层和内侧顶叶区域的区域性脑血流减少，而包括双侧脑桥、壳核和海马在内的皮质下区域的区域性脑血流增加。在快速眼动睡眠行为障碍中，额叶和枕叶区域的脑灌注与颜色辨别测试中的较差表现相关。此外，还发现嗅觉辨别丧失与双侧前海马旁回的区域性脑血流减少之间存在关系，而该区域已知与嗅觉功能有关。本研究进一步提供了快速眼动睡眠行为障碍中区域性脑血流异常的证据，这些异常与帕金森病和路易体痴呆中所见的异常相似。此外，区域性脑血流异常与神经退行性变标志物相关。
