Functional neuroimaging and clinical features of drug naive patients with de novo Parkinson’s disease and probable RBD

Arnaldi, Dario; Morbelli, Silvia; Brugnolo, Andrea; Girtler, Nicola; Picco, Agnese; Ferrara, Michela; Accardo, Jennifer; Buschiazzo, Ambra; Carli, Fabrizio De; Pagani, Marco; Nobili, Flavio

doi:10.1016/j.parkreldis.2016.05.031

Cited by 64 publications

(63 citation statements)

References 32 publications

(44 reference statements)

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“…Removing these studies yielded a significant effect of the UPDRS-III score on the occurrence of RBD (SMD = 0.29; 95% CI 0.20–0.38; p = 0.000); however, heterogeneity was not observed across the studies (I 2 = 17.7%; p = 0.221). Notably, UPDRS-III test performed on the state of “on”, “off” and unknown was reported in 384043, 48304044 and 1717202324252627283132343539414246 of the original studies respectively, which is inappropriate for the further sub-group analysis in this meta-analysis. Therefore, the findings concerning the connection between UPDRS-III score and the occurrence of RBD should be interpreted more cautiously.…”

Section: Resultsmentioning

confidence: 91%

“…Another 1,187 studies were excluded because they were reviews (n = 655), case reports (n = 166), animal studies (n = 306) or editorials (n = 50). Ultimately, 31 articles1278202122232425262728293031323334353637383940414243444546 were included in our analysis (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…However, in this meta-analysis, we cannot distinguish primary RBD from RBD linked to antidepressants since the data were insufficient in the original articles. Besides, in several of the included studies12202224252829303133363738404445, RBD was diagnosed based on a questionnaire or clinical manifestations but not confirmed with PSG. PSG can detect muscle activation patterns during REM sleep, including aberrant chin muscle tone, limb jerking, and hyperkinetic or violent behaviour; however, this technique is not part of the mandatory criteria for a clinical diagnosis254.…”

Section: Discussionmentioning

confidence: 99%

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Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Zhu

Xie

et al. 2017

Sci Rep

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This study aimed to evaluate the clinical variations in patients with Parkinson’s disease (PD) with (PDRBD) or without REM sleep behaviour disorder (RBD) (Non-RBD), and PDRBD patients were classified into Confirmed-RBD (definite diagnosis with polysomnography, PSG) and Probable-RBD (without PSG re-confirmation). The clinical difference between the groups of patients was measured as an odds ratio (OR) or standardized mean difference (SMD, Cohen d). A total of 31 articles with data from 5,785 participants were obtained for our analysis. Overall, the occurrence of Confirmed-RBD was more frequent in male patients (OR = 1.25; p = 0.038), elderly patients (SMD = 0.25; p = 0.000), and patients with longer disease duration (SMD = 0.30; p = 0.000), increased Hoehn-Yahr scale (SMD = 0.30; p = 0.000), and higher UPDRS-III score (SMD = 0.38; p = 0.002). On the other hand, the frequency of Probable-RBD was increased with disease duration (SMD = 0.29; p = 0.000), Hoehn-Yahr scale (SMD = 0.30; p = 0.000), and UPDRS-III score (SMD = 0.26; p = 0.001). Our study indicate that PDRBD patients may have different clinical features compared to patients with Non-RBD.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Zhu

Xie

et al. 2017

Sci Rep

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“…Zhang et al found additional hypometabolism in the caudate nucleus and inferior parietal lobule in patients with postural instability gait disorder compared with tremordominant patients (22). Decreased metabolism in parietaloccipital regions was found in PD patients with RBD compared with PD patients without RBD (23). Compared with patients with PD or PD dementia, DLB patients show more pronounced hypometabolism of the visual association cortices (24).…”

Section: Pd and Cognitive Impairmentmentioning

confidence: 99%

Metabolic Imaging in Parkinson Disease

et al. 2016

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This review focuses on recent human 18 F-FDG PET studies in Parkinson disease. First, an overview is given of the current analytic approaches to metabolic brain imaging data. Next, we discuss how 18 F-FDG PET studies have advanced understanding of the relation between distinct brain regions and associated symptoms in Parkinson disease, including cognitive decline. In addition, the value of 18 F-FDG PET studies in differential diagnosis, identifying prodromal patients, and the evaluation of treatment effects are reviewed. Finally, anticipated developments in the field are addressed.

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“…For example, recent longitudinal studies demonstrated that visual hallucinations and hyposmia, which coincided with a marked temporoparietal and occipital hypometabolism in PD (with or without MCI), were associated with an increased conversion to PDD (104,105). Likewise, PD patients with the rapid-eye-movement sleep behavior disorder showed lower cognitive performance and a higher likelihood of MCI and posterior cortical hypometabolism than did PD patient without this disorder (106). Finally, the aforementioned long-term follow-up study (32) found that patients with posterior cortical hypometabolism exhibited twice the mortality risk of PD patients without such a pattern.…”

Section: F-fdg Pet Imaging Of Cognitive Impairment In Pdmentioning

confidence: 99%

¹⁸F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment

et al. 2017

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the clinical demand and rationale for differential diagnosis in parkinsonism, (2) recognize and differentiate the disease-specific patterns of regional glucose metabolism associated with Parkinson disease and the different atypical parkinsonian syndromes, and (3) identify regional metabolic changes that predict cognitive decline in Parkinson disease.Financial Disclosure: Dr. Meyer receives support from GE and Piramal for a research study outside the present topic. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA category 1 credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through December 2020.Accurate differential diagnosis of parkinsonism is of paramount therapeutic and prognostic importance. In addition, with the development of invasive therapies and novel disease-specific therapies, strategies for patient enrichment in trial populations are of growing importance. Imaging disease-specific patterns of regional glucose metabolism with PET and 18 F-FDG allows for a highly accurate distinction between Parkinson disease (PD) and atypical parkinsonian syndromes, including multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration. On the basis of a preliminary metaanalysis of currently available studies with inclusion of multiple disease groups, we estimated that the diagnostic sensitivity and specificity for visual PET readings supported by voxel-based statistical analyses for diagnosis of atypical parkinsonian syndromes are 91.4% and 90.6%, respectively. The diagnostic specificity of 18 F-FDG PET for diagnosing multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration was consistently shown to be high (.90%), whereas sensitivity was more variable (.75%). It is increasingly acknowledged that cognitive impairment represents a major challenge in PD, with mild cognitive impairment being a prodromal stage of PD with dementia (PDD). In line with clinical and neuropsychologic studies, recent PET studies demonstrated that posterior cortical dysfunction in nondemented PD patients precedes cognitive decline and the development of PDD by several years. Taken together, the current literature underscores the utility of 18 F-FDG PET for diagnostic evaluation of parkinsonism and the promising role of 18 F-FDG PET for assessment and risk stratification of cognitive impairment in PD.

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Functional neuroimaging and clinical features of drug naive patients with de novo Parkinson’s disease and probable RBD

Cited by 64 publications

References 32 publications

Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Metabolic Imaging in Parkinson Disease

¹⁸F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment

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Functional neuroimaging and clinical features of drug naive patients with de novo Parkinson’s disease and probable RBD

Cited by 64 publications

References 32 publications

Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Clinical variations in Parkinson’s disease patients with or without REM sleep behaviour disorder: a meta-analysis

Metabolic Imaging in Parkinson Disease

18F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment

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¹⁸F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment