Department of Neurology, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
Department of Radiology, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
Sleep Med. 2021 Jun;82:125-133. doi: 10.1016/j.sleep.2021.03.041. Epub 2021 Apr 9.
Rapid eye movement sleep behavior disorder (RBD) frequently occurs in Parkinson's disease (PD), however, the exact pathophysiological mechanism underlying its occurrence is not clear. In this study, we explored whether there is abnormal spontaneous neuronal activities and connectivity maps in some brain areas under resting-state in PD patients with RBD.
We recruited 38 PD patients (19 PD with RBD and 19 PD without RBD), and 20 age- and gender-matched normal controls. We used resting-state functional magnetic resonance imaging (RS-fMRI) to analyze regional homogeneity (ReHo) and functional connectivity (FC), and further to reveal the neuronal activity in all subjects.
Compared with the PD without RBD patients, the PD with RBD patients showed a significant increase in regional homogeneity in the left cerebellum, the right middle occipital region and the left middle temporal region, and decreased regional homogeneity in the left middle frontal region. The REM sleep behavioral disorders questionnaire scores were significantly positively correlated with the ReHo values of the left cerebellum. The functional connectivity analysis in which the four regions described above were used as regions of interest revealed increased functional activity between the left cerebellum and bilateral occipital regions, bilateral temporal regions and bilateral supplementary motor area.
The pathophysiological mechanism of PD with RBD may be related to abnormal spontaneous neuronal activity patterns with strong synchronization of cerebellar and visual-motor relevant cortex, and the increased connectivity of the cerebellum with the occipital and motor regions.
快速眼动睡眠行为障碍（RBD）常在帕金森病（PD）中发生，但其发生的确切病理生理机制尚不清楚。本研究旨在探讨 RBD 型 PD 患者静息状态下某些脑区是否存在异常的自发性神经元活动和连接图谱。
我们招募了 38 名 PD 患者（19 名 RBD 型 PD 患者和 19 名非 RBD 型 PD 患者）和 20 名年龄和性别匹配的正常对照者。我们使用静息态功能磁共振成像（RS-fMRI）分析局部一致性（ReHo）和功能连接（FC），进一步揭示所有受试者的神经元活动。
与非 RBD 型 PD 患者相比，RBD 型 PD 患者左侧小脑、右侧中枕叶和左侧中颞叶的局部一致性显著增加，左侧额中回的局部一致性显著降低。快速眼动睡眠行为障碍问卷评分与左侧小脑的 ReHo 值呈显著正相关。以上述四个区域作为感兴趣区的功能连接分析显示，左侧小脑与双侧枕叶、双侧颞叶和双侧辅助运动区之间的功能活动增加。
RBD 型 PD 的病理生理机制可能与小脑和视觉运动相关皮质的自发性神经元活动模式异常、小脑与枕叶和运动区域的连接增加有关。
