Lin Huihui, Cheng Xiaoyu, Xu Yiwen, Wu Jiayu, Zhu Jiangtao, Mao Chengjie, Jiang Zhen
Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People's Republic of China.
Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People's Republic of China.
Neuroradiology. 2025 Jan;67(1):153-162. doi: 10.1007/s00234-024-03492-y. Epub 2024 Oct 30.
Parkinson's disease (PD), a prevalent neurodegenerative disorder, assumes a more adverse prognosis when accompanied by rapid eye movement sleep disorder (RBD). Non-motor symptoms, particularly sleep and emotional disturbances, significantly impair patients' quality of life. This study aimed to investigate the neuroimaging underpinnings of PD-RBD using structural and functional magnetic resonance imaging (MRI) and to explore the associations between these imaging biomarkers and non-motor symptoms.
Brain scans were acquired from 33 PD patients without and 21 with probable RBD (PD-pRBD). Comparative analyses were performed to evaluate structural and functional alterations between the two groups. Additionally, the correlations between neuroimaging metrics and clinical assessment scales were assessed.
PD-pRBD patients demonstrated more pronounced grey matter atrophy, particularly in the putamen and insula. Functional MRI revealed decreased amplitude of low-frequency fluctuations (ALFF) in the bilateral posterior cingulate cortex and left precuneus of PD-pRBD patients. Furthermore, reduced functional connectivity (FC) was observed in specific regions of the whole brain and within the default mode network (DMN) in PD-pRBD. Notably, a negative correlation was found between mean ALFF values in the left posterior cingulate cortex of PD-pRBD patients and Hamilton Depression Rating Scale scores.
PD-pRBD is characterized by more severe grey matter loss and functional MRI abnormalities compared to PD alone. Dysfunction of the posterior cingulate cortex is implicated in more pronounced affective impairments, providing novel insights into the complex pathophysiology of PD-RBD.
帕金森病（PD）是一种常见的神经退行性疾病，伴有快速眼动睡眠障碍（RBD）时预后更差。非运动症状，尤其是睡眠和情绪障碍，会显著损害患者的生活质量。本研究旨在利用结构和功能磁共振成像（MRI）研究PD-RBD的神经影像学基础，并探讨这些影像学生物标志物与非运动症状之间的关联。
对33例无RBD的PD患者和21例可能患有RBD的PD患者（PD-pRBD）进行脑部扫描。进行比较分析以评估两组之间的结构和功能改变。此外，评估神经影像学指标与临床评估量表之间的相关性。
PD-pRBD患者表现出更明显的灰质萎缩，尤其是在壳核和岛叶。功能MRI显示PD-pRBD患者双侧后扣带回皮质和左侧楔前叶低频波动幅度（ALFF）降低。此外，在PD-pRBD患者的全脑特定区域和默认模式网络（DMN）内观察到功能连接（FC）减少。值得注意的是，PD-pRBD患者左侧后扣带回皮质的平均ALFF值与汉密尔顿抑郁量表评分之间存在负相关。
与单纯PD相比，PD-pRBD的特征是灰质损失更严重和功能MRI异常。后扣带回皮质功能障碍与更明显的情感障碍有关，为PD-RBD的复杂病理生理学提供了新的见解。
