Firbank Michael J, Pasquini Jacopo, Best Laura, Foster Victoria, Sigurdsson Hilmar P, Anderson Kirstie N, Petrides George, Brooks David J, Pavese Nicola
Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Brain Imaging Behav. 2024 Dec;18(6):1428-1437. doi: 10.1007/s11682-024-00939-x. Epub 2024 Sep 25.
REM sleep behaviour disorder (RBD) is a parasomnia characterised by dream-enacting behaviour with loss of muscle atonia during REM sleep and is a prodromal feature of α-synucleinopathies like Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. Although cortical-to-subcortical connectivity is well-studied in RBD, cerebellar and subcortical nuclei reciprocal connectivity is less established. Nonetheless, it could be relevant since RBD pathology involves brainstem structures with an ascending gradient. In this study, we utilised resting-state functional MRI to investigate 13 people with isolated RBD (iRBD), 17 with Parkinson's disease and 16 healthy controls. We investigated the connectivity between the basal ganglia, thalamus and regions of the cerebellum. The cerebellum was segmented using a functional atlas, defined by a resting-state network-based parcellation, rather than an anatomical one. Controlling for age, we found a significant group difference (F = 5.47, p = 0.017) in cerebellar-thalamic connectivity, with iRBD significantly lower compared to both control and Parkinson's disease. Specifically, cerebellar areas involved in this connectivity reduction were related to the default mode, language and fronto-parietal resting-state networks. Our findings show functional connectivity abnormalities in subcortical structures that are specific to iRBD and may be relevant from a pathophysiological standpoint. Further studies are needed to investigate how connectivity changes progress over time and whether specific changes predict disease course or phenoconversion.
快速眼动睡眠行为障碍（RBD）是一种异态睡眠，其特征是在快速眼动睡眠期间出现梦境行为且肌肉张力缺失，是帕金森病、路易体痴呆和多系统萎缩等α-突触核蛋白病的前驱特征。尽管在RBD中皮质到皮质下的连接已得到充分研究，但小脑与皮质下核团的相互连接尚未明确建立。然而，这可能是相关的，因为RBD病理学涉及具有上升梯度的脑干结构。在本研究中，我们利用静息态功能磁共振成像来研究13名孤立性RBD（iRBD）患者、17名帕金森病患者和16名健康对照者。我们研究了基底神经节、丘脑和小脑区域之间的连接性。小脑是使用基于静息态网络的分割定义的功能图谱进行分割的，而不是解剖图谱。在控制年龄后，我们发现小脑 - 丘脑连接性存在显著的组间差异（F = 5.47，p = 0.017），iRBD与对照组和帕金森病组相比均显著降低。具体而言，参与这种连接性降低的小脑区域与默认模式、语言和额顶叶静息态网络有关。我们的研究结果表明，iRBD特有的皮质下结构存在功能连接异常，从病理生理学角度来看可能具有相关性。需要进一步研究来调查连接性变化如何随时间进展，以及特定变化是否能预测疾病进程或表型转换。
