From the Center for Neurosciences (F.H., Y.M., C.C.T., A.F., V.D., D.E.), The Feinstein Institute for Medical Research, Manhasset, NY; Center for Advanced Research in Sleep Medicine (J.-F.G., R.B.P., M.V., J.M.), Hôpital du Sacré-Coeur de Montréal; Department of Psychology (J.-F.G., M.V.), Université du Québec à Montréal; Department of Neurology (R.B.P.), Montreal General Hospital; Montreal Neurological Institute (J.-P.S.), McGill University; and Department of Psychiatry (J.M.), University of Montreal, Montréal, Canada.
Neurology. 2014 Feb 18;82(7):620-7. doi: 10.1212/WNL.0000000000000130. Epub 2014 Jan 22.
To determine whether the Parkinson disease-related covariance pattern (PDRP) expression is abnormally increased in idiopathic REM sleep behavior disorder (RBD) and whether increased baseline activity is associated with greater individual risk of subsequent phenoconversion.
For this cohort study, we recruited 2 groups of RBD and control subjects. Cohort 1 comprised 10 subjects with RBD (63.5 ± 9.4 years old) and 10 healthy volunteers (62.7 ± 8.6 years old) who underwent resting-state metabolic brain imaging with (18)F-fluorodeoxyglucose PET. Cohort 2 comprised 17 subjects with RBD (68.9 ± 4.8 years old) and 17 healthy volunteers (66.6 ± 6.0 years old) who underwent resting brain perfusion imaging with ethylcysteinate dimer SPECT. The latter group was followed clinically for 4.6 ± 2.5 years by investigators blinded to the imaging results. PDRP expression was measured in both RBD groups and compared with corresponding control values.
PDRP expression was elevated in both groups of subjects with RBD (cohort 1: p < 0.04; cohort 2: p < 0.005). Of the 17 subjects with long-term follow-up, 8 were diagnosed with Parkinson disease or dementia with Lewy bodies; the others did not phenoconvert. For individual subjects with RBD, final phenoconversion status was predicted using a logistical regression model based on PDRP expression and subject age at the time of imaging (r(2) = 0.64, p < 0.0001).
Latent network abnormalities in subjects with idiopathic RBD are associated with a greater likelihood of subsequent phenoconversion to a progressive neurodegenerative syndrome.
确定特发性 REM 睡眠行为障碍（RBD）中是否存在帕金森病相关协变模式（PDRP）表达异常，以及基线活动增加是否与更大的个体后续表型转化风险相关。
这项队列研究纳入了两组 RBD 和对照组受试者。队列 1 包括 10 名 RBD 患者（63.5 ± 9.4 岁）和 10 名健康志愿者（62.7 ± 8.6 岁），他们接受了（18）F-氟脱氧葡萄糖 PET 静息代谢脑成像；队列 2 包括 17 名 RBD 患者（68.9 ± 4.8 岁）和 17 名健康志愿者（66.6 ± 6.0 岁），他们接受了乙基半胱氨酸二聚体 SPECT 静息脑灌注成像。在研究人员对成像结果不知情的情况下，对后者组进行了 4.6 ± 2.5 年的临床随访。在两组 RBD 患者中均测量了 PDRP 表达，并与相应的对照组值进行了比较。
两组 RBD 患者的 PDRP 表达均升高（队列 1：p < 0.04；队列 2：p < 0.005）。在 17 名进行长期随访的患者中，8 人被诊断为帕金森病或路易体痴呆；其余人未发生表型转化。对于每个 RBD 患者，根据 PDRP 表达和成像时的患者年龄，使用逻辑回归模型预测最终表型转化状态（r(2) = 0.64，p < 0.0001）。
特发性 RBD 患者的潜在网络异常与随后发生进行性神经退行性综合征表型转化的可能性增加相关。
