M Salsone1, A Cerasa2, G Arabia3, M Morelli3, A Gambardella3, L Mumoli3, R Nisticò2, B Vescio2, A Quattrone4. 1. Neuroimaging Research Unit, National Research Council, Catanzaro, Italy. 2. Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy. 3. Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Germaneto, Catanzaro, Italy. 4. Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Germaneto, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy. Electronic address: quattrone@unicz.it.
Abstract
INTRODUCTION: REM sleep behavior disorder (RBD) is a common non motor feature of Parkinson's Disease (PD) affecting about half the patients with this disease. Distinct structural brain tissue abnormalities have been reported in several regions modulating REM sleep of the patients with idiopathic RBD. At the present time, there are no conventional MRI studies investigating patients with PD associated with RBD. METHODS: Herein, we used voxel-based morphometry (VBM) to detect the neuroanatomical profile of PD patients with and without RBD. Optimized VBM was applied to the MRI brain images in 11 PD patients with RBD (PD-RBD), 11 PD patients without RBD (PD) and 18 age-and sex-matched controls. To corroborate VBM findings we used automated volumetric method (FreeSurfer) to quantify subcortical brain regions volumes. Patients and controls also underwent DAT-SPECT and cardiac MIBG scintigraphies. RESULTS: The VBM analysis showed markedly reduced gray matter volume in the right thalamus of PD-RBD patients in comparison with PD patients and controls. Automatic thalamic segmentation in PD-RBD patients showed a bilaterally reduced thalamic volume as compared with PD patients or controls. All PD patients (with and without RBD) showed a reduced tracer uptake on DAT-SPECT and cardiac MIBG scintigraphies as compared to controls. CONCLUSIONS: Our findings suggest that the presence of RBD symptoms in PD patients is associated with a reduced thalamic volume suggesting a pathophysiologic role of the thalamus in the complex circuit causing RBD.
INTRODUCTION:REM sleep behavior disorder (RBD) is a common non motor feature of Parkinson's Disease (PD) affecting about half the patients with this disease. Distinct structural brain tissue abnormalities have been reported in several regions modulating REM sleep of the patients with idiopathic RBD. At the present time, there are no conventional MRI studies investigating patients with PD associated with RBD. METHODS: Herein, we used voxel-based morphometry (VBM) to detect the neuroanatomical profile of PDpatients with and without RBD. Optimized VBM was applied to the MRI brain images in 11 PDpatients with RBD (PD-RBD), 11 PDpatients without RBD (PD) and 18 age-and sex-matched controls. To corroborate VBM findings we used automated volumetric method (FreeSurfer) to quantify subcortical brain regions volumes. Patients and controls also underwent DAT-SPECT and cardiac MIBG scintigraphies. RESULTS: The VBM analysis showed markedly reduced gray matter volume in the right thalamus of PD-RBDpatients in comparison with PDpatients and controls. Automatic thalamic segmentation in PD-RBDpatients showed a bilaterally reduced thalamic volume as compared with PDpatients or controls. All PDpatients (with and without RBD) showed a reduced tracer uptake on DAT-SPECT and cardiac MIBG scintigraphies as compared to controls. CONCLUSIONS: Our findings suggest that the presence of RBD symptoms in PDpatients is associated with a reduced thalamic volume suggesting a pathophysiologic role of the thalamus in the complex circuit causing RBD.
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