Wang Xi, Li Yuming, Li Boyi, Shang Huifang, Yang Jing
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Sleep Med. 2025 Feb;126:114-121. doi: 10.1016/j.sleep.2024.12.003. Epub 2024 Dec 4.
Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a robust prodromal marker of α-synucleinopathies. Increased neuroimaging studies have explored the morphological abnormalities in iRBD, but yielded inconsistent results.
We conducted a systematic review and a voxel-wise meta-analysis of whole-brain voxel-based morphometry (VBM) studies using the anisotropic effect size version of seed-based d mapping (AES-SDM) to investigate gray matter volume (GMV) alterations in iRBD.
A total of 11 studies with 12 comparisons that included 341 iRBD patients and 288 healthy controls (HCs) were identified. Patients with iRBD showed decreased GMV in the bilateral superior frontal gyri and gyrus rectus, the right temporal pole, right caudate, and right olfactory cortex, while increased GMV in the bilateral cerebellum and thalamus, and left superior occipital gyrus, relative to HCs. These findings remained largely unchanged in jackknife sensitivity analyses.
These abnormalities may represent the structural brain underpinnings of cognitive and sensorimotor dysfunctions in patients with iRBD and could enhance our understanding of the early signs of neurodegeneration in the prodromal stage of a-synucleinopathies.
特发性快速眼动睡眠行为障碍（iRBD）是α-突触核蛋白病的一个强有力的前驱标志物。越来越多的神经影像学研究探讨了iRBD中的形态学异常，但结果并不一致。
我们进行了一项系统评价，并使用基于种子的映射的各向异性效应大小版本（AES-SDM）对基于体素的形态计量学（VBM）全脑研究进行了体素级荟萃分析，以研究iRBD中的灰质体积（GMV）变化。
共纳入11项研究，包含12组比较，涉及341例iRBD患者和288例健康对照（HCs）。与HCs相比，iRBD患者双侧额上回和直回、右侧颞极、右侧尾状核和右侧嗅觉皮质的GMV降低，而双侧小脑、丘脑以及左侧枕上回的GMV增加。在留一法敏感性分析中，这些发现基本保持不变。
这些异常可能代表了iRBD患者认知和感觉运动功能障碍的脑结构基础，并可能增进我们对α-突触核蛋白病前驱期神经退行性变早期迹象的理解。
