Lee Dong Ah, Lee Ho-Joon, Park Kang Min
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
J Neuroimaging. 2025 Jan-Feb;35(1):e70009. doi: 10.1111/jon.70009.
Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white matter damage in patients with isolated rapid eye movement sleep behavior disorder (RBD) using PSMD.
We enrolled patients with newly diagnosed isolated RBD confirmed by polysomnography and age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was conducted using a 3-Tesla MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the Functional Magnetic Resonance Imaging of the Brain Software Library program. We compared the incidence of PSMD between patients with RBD and healthy controls and performed a correlation analysis between PSMD and clinical factors in patients with RBD.
Thirty patients with isolated RBD and 41 healthy controls were enrolled. The PSMD was significantly higher in patients with RBD than that in the healthy controls (3.078 vs. 2.746 × 10 mm/s, p = 0.001). In addition, PSMD positively correlated with age in patients with RBD (r = 0.477, p = 0.007). However, PSMD was not associated with other clinical or polysomnographic factors.
Patients with isolated RBD had a higher PSMD than healthy controls, indicating the evidence of white matter damage in patients with RBD. This finding highlights the potential of PSMD as a marker for detecting white matter damage, which may be related to small vessel diseases, in patients with sleep disorders.
骨骼化平均扩散率峰值宽度（PSMD）是一种新型的白质损伤标志物，可能与小血管疾病有关。本研究旨在使用PSMD调查孤立性快速眼动睡眠行为障碍（RBD）患者白质损伤的情况。
我们纳入了经多导睡眠图确诊的新诊断孤立性RBD患者以及年龄和性别匹配的健康对照者。使用3特斯拉磁共振成像扫描仪进行扩散张量成像（DTI）。我们通过几个步骤基于DTI测量PSMD，包括预处理、骨骼化、应用自定义掩码和直方图分析，使用脑功能磁共振成像软件库程序。我们比较了RBD患者和健康对照者中PSMD的发生率，并对RBD患者的PSMD与临床因素进行了相关性分析。
纳入了30例孤立性RBD患者和41例健康对照者。RBD患者的PSMD显著高于健康对照者（3.078对2.746×10⁻³mm²/s，p = 0.001）。此外，RBD患者的PSMD与年龄呈正相关（r = 0.477，p = 0.007）。然而，PSMD与其他临床或多导睡眠图因素无关。
孤立性RBD患者的PSMD高于健康对照者，表明RBD患者存在白质损伤证据。这一发现突出了PSMD作为检测睡眠障碍患者白质损伤标志物的潜力，白质损伤可能与小血管疾病有关。
