Sarasso Elisabetta, Gardoni Andrea, Marelli Sara, Balestrino Roberta, Zenere Lucia, Castelnuovo Alessandra, Malcangi Massimo, Basaia Silvia, Grassi Andrea, Tettamanti Andrea, Canu Elisa, Ferini-Strambi Luigi, Filippi Massimo, Agosta Federica
Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Mov Disord. 2024 Sep;39(9):1567-1577. doi: 10.1002/mds.29911. Epub 2024 Jul 4.
Isolated rapid eye movement sleep behavioral disorder (iRBD) can precede neurodegenerative diseases. There is an urgent need for biomarkers to aid early intervention and neuroprotection.
The aim is to assess quantitative motor, cognitive, and brain magnetic resonance imaging (MRI) characteristics in iRBD patients.
Thirty-eight polysomnography-confirmed iRBD patients and 28 age- and sex-matched healthy controls underwent clinical, cognitive, and motor functional evaluations, along with brain MRI. Motor tasks included nine-hole peg test, five-times-sit-to-stand test, timed-up-and-go test, and 4-meter walking test with and without cognitive dual task. Quantitative spatiotemporal gait parameters were obtained using an optoelectronic system. Brain MRI analysis included functional connectivity (FC) of the main resting-state networks, gray matter (GM) volume using voxel-based morphometry, cortical thickness, and deep GM and brainstem volumes using FMRIB's Integrated Registration and Segmentation Tool and FreeSurfer.
iRBD patients relative to healthy subjects exhibited a poorer performance during the nine-hole peg test and five-times-sit-to-stand test, and greater asymmetry of arm-swing amplitude and stride length variability during dual-task gait. Dual task significantly worsened the walking performance of iRBD patients more than healthy controls. iRBD patients exhibited nonmotor symptoms, and memory, abstract reasoning, and visuospatial deficits. iRBD patients exhibited decreased FC of pallidum and putamen within the basal ganglia network and occipital and temporal areas within the visuo-associative network, and a reduced volume of the supramarginal gyrus. Brain functional alterations correlated with gait changes.
Subtle motor and nonmotor alterations were identified in iRBD patients, alongside brain structural and functional MRI changes. These findings may represent early signs of neurodegeneration and contribute to the development of predictive models for progression to parkinsonism. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
孤立性快速眼动睡眠行为障碍（iRBD）可能先于神经退行性疾病出现。迫切需要生物标志物来辅助早期干预和神经保护。
旨在评估iRBD患者的定量运动、认知和脑磁共振成像（MRI）特征。
38例经多导睡眠图确诊的iRBD患者和28例年龄及性别匹配的健康对照者接受了临床、认知和运动功能评估以及脑MRI检查。运动任务包括九孔插板试验、五次坐立试验、计时起立行走试验以及有无认知双重任务的4米步行试验。使用光电系统获取定量时空步态参数。脑MRI分析包括主要静息态网络的功能连接（FC）、基于体素的形态学测量的灰质（GM）体积、皮质厚度以及使用FMRIB的综合配准和分割工具及FreeSurfer测量的深部GM和脑干体积。
与健康受试者相比，iRBD患者在九孔插板试验和五次坐立试验中的表现较差，在双重任务步态期间手臂摆动幅度和步长变异性的不对称性更大。双重任务对iRBD患者步行性能的恶化程度明显大于健康对照者。iRBD患者表现出非运动症状以及记忆、抽象推理和视觉空间缺陷。iRBD患者在基底神经节网络内苍白球和壳核以及视觉联合网络内枕叶和颞叶区域的FC降低，顶上小叶体积减小。脑功能改变与步态变化相关。
在iRBD患者中发现了细微的运动和非运动改变，同时伴有脑结构和功能MRI变化。这些发现可能代表神经退行性变的早期迹象，并有助于开发向帕金森综合征进展的预测模型。© 2024作者。由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版的《运动障碍》。
