Brain Neuroimaging of Rapid Eye Movement Sleep Behavior Disorder in Parkinson’s Disease: A Systematic Review

Abstract

Background: REM-sleep behaviour disorder (RBD) is a parasomnia and a common comorbidity in Parkinson’s disease (PD). There is evidence that the presence of RBD is associated with more severe PD. The differences in the clinical manifestations and the natural history are likely to imply underlying differences in the pathophysiology among PD patients with and without RBD. The increasing number of neuroimaging studies support this notion. Objective: Our primary objective was to review the current evidence regarding the brain neuroimaging findings in PD patients with RBD (PDRBD). Methods: A systematic review of articles, published in PubMed between January 1, 2000 and September 23, 2020 was performed. We evaluate previous studies that assessed PD patients with RBD using various brain structural and functional magnetic resonance imaging (MRI) techniques and brain nuclear medicine imaging. Results: Twenty-nine studies, involving a total of 3,347 PD subjects among which 912 subjects with PDRBD, met the selection criteria and were included. The presence of RBD in PD patients is associated with structural and functional alterations in several brain regions, mainly in brainstem, limbic structures, frontotemporal cortex, and basal ganglia, raising the hypothesis of a PDRBD neuroimaging phenotype. Conclusion: The current review provides up-to-date knowledge in this field and summarizes the neurobiological/neuroimaging substrate of RBD in PD.

Neuroanatomical findings in isolated REM sleep behavior disorder and early Parkinson’s disease: a Voxel-based morphometry study

“…In agreement with previous literature (Chen et al, 2022 ; Jia et al, 2022 ; Matzaras et al, 2022 ; Rahayel et al, 2019 ), our study showed the presence of decreased GM volume in frontal areas (right orbitofrontal cortex and bilateral precentral gyrus) in iRBD patients compared to both PD/pRBD and HC, and in temporo-occipital regions (lingual and fusiform gyri) in both iRBD and PD/pRBD patients in comparison with HC. Furthermore, we also reported the presence of increased GM volume in superior frontal gyrus in iRBD patients compared to PD/pRBD.…”

“…Advanced neuroimaging techniques are a promising method to identify structural and functional features that could assess the risk of conversion toward alpha-synucleinopathies. Very recently, neuroimaging data, mostly from structural MRI, combining different techniques, have been reviewed (Campabadal et al, 2019 ; Ghaderi et al, 2023 ; Valli et al, 2022 ), highlighting the presence of cortical and subcortical abnormalities, involving basal ganglia and fronto-temporal cortices in iRBD patients (Unger et al, 2010 , Rahayel et al, 2015 , 2018a , b , Chen et al, 2022 , Hanyu et al, 2012 , Matzaras et al, 2022 , Scherfler et al, 2011 ) and in PD with RBD (Boucetta et al, 2016 ; Jia et al, 2022 ; Lim et al, 2016 ; Rahayel et al, 2019 ; Salsone et al, 2014 ). Although PD with RBD patients had a more prominent involvement of the thalamus, putamen, insula, precuneus, para-hippocampal, and postcentral gyrus, iRBD had the internal capsule, caudate, thalamus, and fornix more involved (Campabadal et al, 2019 ; Valli et al, 2022 ).…”

Neuroimaging of rapid eye movement sleep behavior disorder and its relation to Parkinson's disease

“…Given the importance of iRBD, there are significant interests in studying the underlying neural mechanisms driving this disorder, its conversion to synucleinopathies, and its manifestation within PD (Campabadal et al, 2021; Heller et al, 2017; Högl et al, 2018; Matzaras et al, 2021). The suspected pathophysiology of iRBD stems from the dysfunction of the subcoeruleus complex in the pons and is seen as one of the possible driving factors in initiating the clinical development (Boeve, 2010).…”

Parkinson’s Disease: A Narrative Review on Potential Molecular Mechanisms of Sleep Disturbances, REM Behavior Disorder, and Melatonin

“…There are functional changes in many brain regions, mainly in the brainstem, limbic structures, frontotemporal cortex, and basal ganglia. [169] A significant increase in regional homogeneity in the left cerebellum, the right middle occipital region, and the left middle temporal region.…”