National Reference Network for Narcolepsy, Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Montpellier, Cedex 5, France.
INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
Sci Rep. 2018 May 8;8(1):7304. doi: 10.1038/s41598-018-25547-w.
The pathophysiology of rapid eye movement sleep behavior disorder (RBD) associated with narcolepsy type 1 (NT1) is still poorly understood, potentially distinct from idiopathic RBD (iRBD), but may share affected common pathways. We investigated whether MIBG cardiac uptake differs between iRBD and NT1 comorbid with RBD. Thirty-four patients with NT1-RBD and 15 patients with iRBD underwent MIBG cardiac scintigraphy. MIBG uptake was measured by calculating the early and delayed heart to mediastinum (H/M) ratios. A delayed H/M ratio lower than 1.46 was considered abnormal based on a population of 78 subjects without neurological or cardiac diseases. Patients with iRBD were older, had an older RBD onset age and higher REM sleep phasic and tonic muscular activities than NT1-RBD. Lower delayed and early H/M ratios were associated with iRBD, but not with NT1-RBD, in crude and adjusted associations. The delayed H/M ratio differed between iRBD and controls, after adjustment, but not between patients with NT1-RBD and controls. In conclusion, the MIBG cardiac uptake difference between NT1-RBD and iRBD supports the hypothesis of different processes involved in RBD pathogenesis, providing for the first time a cardiac biomarker to differentiate those disorders.
快速眼动睡眠行为障碍（RBD）与 1 型发作性睡病（NT1）相关的病理生理学仍知之甚少，可能与特发性 RBD（iRBD）不同，但可能存在共同的受影响途径。我们研究了 iRBD 和 NT1 合并 RBD 患者之间的 MIBG 心脏摄取是否存在差异。34 例 NT1-RBD 患者和 15 例 iRBD 患者接受了 MIBG 心脏闪烁显像。通过计算早期和延迟心脏与纵隔（H/M）比值来测量 MIBG 摄取。根据无神经或心脏疾病的 78 例受试者的人群，延迟 H/M 比值低于 1.46 被认为异常。iRBD 患者年龄较大，RBD 发病年龄较大，快速眼动睡眠相位和紧张性肌肉活动较高。在未调整和调整后的关联中，较低的延迟和早期 H/M 比值与 iRBD 相关，但与 NT1-RBD 无关。结论：NT1-RBD 和 iRBD 之间的 MIBG 心脏摄取差异支持 RBD 发病机制涉及不同过程的假设，首次提供了一种心脏生物标志物来区分这些疾病。
