Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain.
Sleep Med Rev. 2021 Oct;59:101495. doi: 10.1016/j.smrv.2021.101495. Epub 2021 Apr 22.
Isolated rapid eye movement sleep behavior disorder (iRBD) is a harbinger for developing clinical synucleinopathies. Magnetic resonance imaging (MRI) has been suggested as a tool for understanding the brain bases of iRBD and its evolution. This review systematically analyzed original full text articles on structural and functional MRI in patients with video-polysomnography-confirmed iRBD according to systematic procedures suggested by Reviews and Meta-analyses (PRISMA). The literature search was conducted via the PubMed database for articles related to structural and functional MRI in iRBD from 2000 to 2020. Investigations to date have been diverse in terms of methodology, but most agree that patients with iRBD have structural changes in deep gray matter nuclei, cortical gray matter atrophy, and disrupted functional connectivity within the basal ganglia, the cortico-striatal and cortico-cortical networks. Furthermore, there is evidence that MRI detects structural and functional brain changes associated with the motor and non-motor symptoms of iRBD. The current review highlights the need for larger multicenter and longitudinal studies, using complex approaches based on data-driven and unsupervised machine learning that will help to identify structural and functional patterns of brain degeneration. In turn, this may even allow for the prediction of subsequent phenoconversion from iRBD to the clinically defined synucleinopathies.
孤立性快速眼动睡眠行为障碍（iRBD）是发展为临床神经核蛋白病的先兆。磁共振成像（MRI）已被提议作为理解 iRBD 及其演变的大脑基础的工具。本综述按照综述和荟萃分析（PRISMA）建议的系统程序，系统地分析了经视频多导睡眠图证实的 iRBD 患者的结构和功能 MRI 的原始全文文章。文献检索通过 PubMed 数据库进行，检索了 2000 年至 2020 年与 iRBD 的结构和功能 MRI 相关的文章。迄今为止的研究在方法上存在多样性，但大多数研究都认为 iRBD 患者存在深部灰质核团的结构变化、皮质灰质萎缩以及基底神经节、皮质纹状体和皮质皮质网络内的功能连接中断。此外，有证据表明 MRI 可检测与 iRBD 的运动和非运动症状相关的结构和功能脑变化。本综述强调了需要进行更大规模的多中心和纵向研究，使用基于数据驱动和无监督机器学习的复杂方法，这将有助于识别大脑退化的结构和功能模式。反过来，这甚至可能允许预测随后从 iRBD 到临床定义的神经核蛋白病的表型转化。
