Roura Ignacio, Pardo Jèssica, Martín-Barceló Cristina, Oltra Javier, Campabadal Anna, Sala-Llonch Roser, Bargalló Núria, Serradell Mònica, Pont-Sunyer Claustre, Gaig Carles, Mayà Gerard, Montini Angelica, Junqué Carme, Iranzo Alex, Segura Bàrbara
Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Mov Disord. 2025 Apr;40(4):704-715. doi: 10.1002/mds.30126. Epub 2025 Jan 28.
Isolated rapid-eye movement (REM) sleep behavior disorder (iRBD) is characterized by abnormal behaviors in REM sleep and is considered as a prodromal symptom of alpha-synucleinopathies. Resting-state functional magnetic resonance imaging (rsfMRI) studies have unveiled altered functional connectivity (rsFC) in patients with iRBD. However, the associations between intra- and inter-network rsFC with clinical symptoms and neuropsychological functioning in iRBD remain unclear.
To characterize intra- and inter-network rsFC in iRBD patients using a data-driven approach and to assess its associations with clinical features and cognitive functioning.
Forty-two patients with iRBD and 45 healthy controls (HC) underwent rsfMRI and comprehensive neuropsychological testing. Resting-state networks were characterized using independent component analyses. Group differences in intra- and inter-network rsFC and their associations with clinical and neuropsychological data were studied. A threshold of corrected P < 0.05 was used in all the analyses.
iRBD patients displayed lower intra-network rsFC within basal ganglia, visual, sensorimotor, and cerebellar networks, relative to HC. Mean rsFC strength within the basal ganglia network positively correlated with processing speed and negatively with the non-motor symptoms in iRBD patients. Reduced inter-network rsFC between sensorimotor and visual medial networks was observed in iRBD patients, which was associated with global cognitive status.
iRBD is characterized by both reductions in intra-network rsFC in cortical and subcortical networks and inter-network dysconnectivity between sensorimotor and visual networks. Abnormalities in intra- and inter-network rsFC are associated with cognitive performance and non-motor symptoms, suggesting the utility of both rsFC measures as imaging markers in prodromal alpha-synucleinopathies. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
孤立性快速眼动（REM）睡眠行为障碍（iRBD）的特征是REM睡眠中的异常行为，被认为是α-突触核蛋白病的前驱症状。静息态功能磁共振成像（rsfMRI）研究揭示了iRBD患者功能连接性（rsFC）的改变。然而，iRBD中网络内和网络间rsFC与临床症状及神经心理功能之间的关联仍不清楚。
采用数据驱动方法描述iRBD患者的网络内和网络间rsFC，并评估其与临床特征和认知功能的关联。
42例iRBD患者和45名健康对照（HC）接受了rsfMRI和全面的神经心理测试。使用独立成分分析来表征静息态网络。研究网络内和网络间rsFC的组间差异及其与临床和神经心理数据的关联。所有分析均采用校正P<0.05的阈值。
与HC相比，iRBD患者在基底神经节、视觉、感觉运动和小脑网络内的网络内rsFC较低。基底神经节网络内的平均rsFC强度与iRBD患者的处理速度呈正相关，与非运动症状呈负相关。在iRBD患者中观察到感觉运动和视觉内侧网络之间的网络间rsFC降低，这与整体认知状态相关。
iRBD的特征是皮质和皮质下网络内的网络内rsFC降低以及感觉运动和视觉网络之间的网络间连接障碍。网络内和网络间rsFC的异常与认知表现和非运动症状相关，表明这两种rsFC测量方法作为前驱性α-突触核蛋白病的成像标志物具有实用性。© 2025作者。由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版的《运动障碍》。
