Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Brain Behav. 2024 Oct;14(10):e70057. doi: 10.1002/brb3.70057.
Strong indications support the notion that idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) acts as a precursor to multiple α-synucleinopathies, including Parkinson's disease and dementia with Lewy bodies. Despite numerous investigations into the alterations in cortical thickness and the volume of subcortical areas associated with this condition, comprehensive studies on the cortical surface morphology, focusing on gyrification and sulcal depth changes, are scarce. The purpose of this research was to explore the cortical surface morphology in individuals with probable iRBD (piRBD), to pinpoint early-phase diagnostic markers.
This study included 30 piRBD patients confirmed using the RBD Screening Questionnaire (RBDSQ) and 33 control individuals selected from the Parkinson's Progression Markers Initiative (PPMI) database. They underwent neurophysiological tests and MRI scans. The FreeSurfer software was utilized to estimate cortical thickness (CTH), cortical and subcortical volumetry, local gyrification index (LGI), and sulcus depth (SD). Subsequently, these parameters were compared between the two groups. Additionally, linear correlation analysis was employed to estimate the relationship between brain morphological parameters and clinical parameters.
Compared to the healthy control (HC), piRBD patients exhibited a significant reduction in CTH, LGI, and cortical volume in the bilateral superior parietal, lateral occipital, orbitofrontal, temporo-occipital, bilateral rostral middle frontal, inferior parietal, and precentral brain regions. Moreover, a significant and notable correlation was observed between CTH and Geriatric Depression Scale (GDS), letter-number sequencing (LTNS), the Benton Judgment of Line Orientation (BJLO) test, and the symbol digit modalities test (SDMT) in several brain regions encompassing the motor cortex.
Patients with piRBD displayed widespread atrophy in various brain regions, predominantly covering the motor and sensory cortex. Furthermore, LGI could serve as a prognostic biomarker of disease's progression in piRBD.
大量证据表明，特发性快速眼动（REM）睡眠行为障碍（iRBD）是多种α-突触核蛋白病的前驱症状，包括帕金森病和路易体痴呆。尽管有许多研究探讨了与这种疾病相关的皮质厚度和皮质下区域体积的改变，但针对皮质表面形态的全面研究，包括脑回和脑沟深度的变化，却相对较少。本研究旨在探索可能的 iRBD（piRBD）患者的皮质表面形态，以确定早期诊断标志物。
本研究纳入了 30 名经 RBD 筛查问卷（RBDSQ）确诊的 piRBD 患者和 33 名来自帕金森进展标志物倡议（PPMI）数据库的对照个体。他们接受了神经生理学测试和 MRI 扫描。使用 FreeSurfer 软件估计皮质厚度（CTH）、皮质和皮质下容积、局部脑回指数（LGI）和脑沟深度（SD）。然后，比较两组之间的这些参数。此外，还进行了线性相关分析，以评估脑形态学参数与临床参数之间的关系。
与健康对照组（HC）相比，piRBD 患者双侧顶上回、外侧枕叶、眶额回、颞枕叶、双侧额中回、下顶叶和中央前回的 CTH、LGI 和皮质体积显著降低。此外，在包括运动皮质在内的几个脑区，CTH 与老年抑郁量表（GDS）、字母数字序列（LTNS）、本顿线定向判断测试（BJLO）和符号数字模态测试（SDMT）之间存在显著且显著的相关性。
piRBD 患者表现出广泛的脑区萎缩，主要涉及运动和感觉皮质。此外，LGI 可能成为 piRBD 疾病进展的预后生物标志物。
