Mild cognitive impairment and abnormal brain metabolic expression in idiopathic REM sleep behavior disorder

Yoo, Dallah; Lee, Jee Young; Kim, Yu Kyeong; Yoon, Eun Jin; Kim, Heejung; Kim, Ryul; Nam, Hyunwoo; Jeon, Beomseok

doi:10.1016/j.parkreldis.2021.07.022

Cited by 7 publications

(19 citation statements)

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“… 39 Recently, our group reported that dnPDRBD-RP predicted cognitive decline in patients with iRBD. 5 The dnPDRBD-RP showed a relative metabolic decrease in the parietal and occipital cortex and precuneus, highlighting the importance of hypometabolism in posterior brain regions predicting disease progression in patients with iRBD. On the other hand, although MCI and MPS have been suggested as important predictive markers for phenoconversion to PD/DLB in patients with iRBD, 40 neither of them significantly associated with higher phenoconversion rate in the current study.…”

Section: Discussionmentioning

confidence: 95%

“…2 Similarly, in a previous study of our cohort of patients with iRBD, we found a phenoconversion rate of 27.3% to PD, DLB, or MSA at a mean follow-up of 3 years, and the phenoconversion rate estimated using the Kaplan-Meier method was 35.5% at 5 years. 3 Studies on cognition in patients with iRBD identified impairments in multiple cognitive domains, such as attention, executive function, episodic memory, and visuospatial abilities, 4,5 and a high prevalence of mild cognitive impairment (MCI), from 32% to 50%. 6,7 Moreover, long-term follow-up studies found that >90% of patients with RBD who later developed DLB had MCI at baseline.…”

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confidence: 99%

“…Studies on cognition in patients with iRBD identified impairments in multiple cognitive domains, such as attention, executive function, episodic memory, and visuospatial abilities, 4 , 5 and a high prevalence of mild cognitive impairment (MCI), from 32% to 50%. 6 , 7 Moreover, long-term follow-up studies found that >90% of patients with RBD who later developed DLB had MCI at baseline.…”

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confidence: 99%

“… 16 Recently, we found that relative hypometabolism in the occipital area persisted during the follow-up period in patients with iRBD who later developed DLB. 17 Also, cognitive deterioration in patients with iRBD was correlated with expression of the metabolic pattern derived from patients with de novo PD with prolonged RBD symptoms before developing parkinsonism (dnPDRBD-RP), 5 characterized by relative hypometabolism in the occipital and precuneus cortex and relative hypermetabolism in the thalamus and putamen/globus pallidus. 18 These results suggest that there are specific metabolic changes that reflect prodromal features of PD before motor symptoms appear in patients with iRBD.…”

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confidence: 99%

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Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder

et al. 2022

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Background and Objectives:Mild cognitive impairment (MCI) in isolated REM sleep behavior disorder (iRBD) is a risk factor for the subsequent neurodegeneration. We aimed to identify brain metabolism and functional connectivity changes related to MCI in patients with iRBD and the neuroimaging markers’ predictive value for phenoconversion.Methods:This is a prospective cohort study of iRBD patients with a mean follow-up of 4.2 ± 2.6 years. At baseline, the patients with iRBD and age- and sex-matched healthy controls (HC) underwent 18F-fluorodeoxyglucose (FDG)-PET and resting-state fMRI scans and performed a comprehensive neuropsychological test battery. Voxel-wise group comparisons for FDG-PET data were performed using a general linear model. Seed-based connectivity maps were computed using brain regions showing significant hypometabolism associated with MCI in iRBD patients and compared between groups. A Cox regression analysis was applied to investigate the association between brain metabolism and a risk of phenoconversion.Results:Forty patients with iRBD, including 21 with MCI (iRBD-MCI) and 19 with normal cognition (iRBD-NC), and 24 HC were included in the present study. The iRBD-MCI group revealed relative hypometabolism in the inferior parietal lobule, lateral and medial occipital, and middle and inferior temporal cortex bilaterally compared to HC and the iRBD-NC group. In seed-based connectivity analyses, the iRBD-MCI group exhibited decreased functional connectivity of the left angular gyrus with the occipital cortex. Of 40 iRBD patients, 12 patients converted to Parkinson’s disease (PD) or dementia with Lewy bodies (DLB). Hypometabolism of the occipital pole (hazard ratio [95% confidence interval] = 6.652 [1.387 – 31.987]), medial occipital (4.450 [1.143 – 17.327]), and precuneus (3.635 [1.009 – 13.093]) was associated with higher phenoconversion rate to PD/DLB.Discussion:MCI in iRBD is related to functional and metabolic changes in broad brain areas, particularly the occipital and parietal areas. Moreover, hypometabolism in these brain regions was a predictor of phenoconversion to PD or DLB. Evaluation of cognitive function and neuroimaging characteristics could be useful for risk stratification in iRBD patients.

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Section: Discussionmentioning

confidence: 95%

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Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder

et al. 2022

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“…48,49 Another cohort found insula volume was decreased in both MCI-LB and MCI-AD compared with controls, but found no significant difference between MCI-AD and MCI-LB in a region of interest analysis and no difference between the groups in the insula using a voxel-wise analysis. 47 Low occipital uptake on metabolism/perfusion imaging: MCI-LB patients have consistently demonstrated reduced fluorodeoxyglucose (FDG) PET uptake in posterior brain areas 15,17,[51][52][53][54] One recent study found that visual rating of FDG PET demonstrated an accuracy of 77% to differentiate MCI-LB from MCI-AD, 52 whereas another found that 50% of MCI-LB had primary visual cortex hypometabolism, compared with 24% of MCI-AD. 17 Another study found that using the cingulate:cuneus/precuneus ratio demonstrated sensitivity of 59% and specificity of 90% to differentiate MCI-LB from MCI-AD.…”

Section: Potential Biomarkers (Table 4)mentioning

confidence: 99%

Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta‐analysis

Donaghy

Carrarini

Ferreira

et al. 2023

Alzheimer's & Dementia

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Introduction Operationalized research criteria for mild cognitive impairment with Lewy bodies (MCI‐LB) were published in 2020. The aim of this systematic review and meta‐analysis was to review the evidence for the diagnostic clinical features and biomarkers in MCI‐LB set out in the criteria. Methods MEDLINE, PubMed, and Embase were searched on 9/28/22 for relevant articles. Articles were included if they presented original data reporting the rates of diagnostic features in MCI‐LB. Results Fifty‐seven articles were included. The meta‐analysis supported the inclusion of the current clinical features in the diagnostic criteria. Evidence for striatal dopaminergic imaging and meta‐iodobenzylguanidine cardiac scintigraphy, though limited, supports their inclusion. Quantitative electroencephalogram (EEG) and fluorodeoxyglucose positron emission tomography (PET) show promise as diagnostic biomarkers. Discussion The available evidence largely supports the current diagnostic criteria for MCI‐LB. Further evidence will help refine the diagnostic criteria and understand how best to apply them in clinical practice and research. Highlights A meta‐analysis of the diagnostic features of MCI‐LB was carried out. The four core clinical features were more common in MCI‐LB than MCI‐AD/stable MCI. Neuropsychiatric and autonomic features were also more common in MCI‐LB. More evidence is needed for the proposed biomarkers. FDG‐PET and quantitative EEG show promise as diagnostic biomarkers in MCI‐LB.

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Prodromal dementia with Lewy bodies in REM sleep behavior disorder: A multicenter study

Joza,

Hu,

Jung

et al. 2023

Alzheimer's & Dementia

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IntroductionIsolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) is a powerful early predictor of dementia with Lewy bodies (DLB) and Parkinson's disease (PD). This provides an opportunity to directly observe the evolution of prodromal DLB and to identify which cognitive variables are the strongest predictors of evolving dementia.MethodsIRBD participants (n = 754) from 10 centers of the International RBD Study Group underwent annual neuropsychological assessment. Competing risk regression analysis determined optimal predictors of dementia. Linear mixed‐effect models determined the annual progression of neuropsychological testing.ResultsReduced attention and executive function, particularly performance on the Trail Making Test Part B, were the strongest identifiers of early DLB. In phenoconverters, the onset of cognitive decline began up to 10 years prior to phenoconversion. Changes in verbal memory best differentiated between DLB and PD subtypes.DiscussionIn iRBD, attention and executive dysfunction strongly predict dementia and begin declining several years prior to phenoconversion.

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Mild cognitive impairment and abnormal brain metabolic expression in idiopathic REM sleep behavior disorder

Cited by 7 publications

References 30 publications

Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder

Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder

Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta‐analysis

Prodromal dementia with Lewy bodies in REM sleep behavior disorder: A multicenter study

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