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{"title":"Understanding REM Sleep Behavior Disorder through Functional MRI: A Systematic Review.","authors":"Lachlan Churchill, Yu-Chi Chen, Simon J G Lewis, Elie Matar","doi":"10.1002/mds.29898","DOIUrl":null,"url":null,"abstract":"<p><p>Neuroimaging studies in rapid eye movement sleep behavior disorder (RBD) can inform fundamental questions about the pathogenesis of Parkinson's disease (PD). Across modalities, functional magnetic resonance imaging (fMRI) may be better suited to identify changes between neural networks in the earliest stages of Lewy body diseases when structural changes may be subtle or absent. This review synthesizes the findings from all fMRI studies of RBD to gain further insight into the pathophysiology and progression of Lewy body diseases. A total of 32 studies were identified using a systematic review conducted according to PRISMA guidelines between January 2000 to February 2024 for original fMRI studies in patients with either isolated RBD (iRBD) or RBD secondary to PD. Common functional alterations were detectable in iRBD patients compared with healthy controls across brainstem nuclei, basal ganglia, frontal and occipital lobes, and whole brain network measures. Patients with established PD and RBD demonstrated decreased functional connectivity across the whole brain and brainstem nuclei, but increased functional connectivity in the cerebellum and frontal lobe compared with those PD patients without RBD. Finally, longitudinal changes in resting state functional connectivity were found to track with disease progression. Currently, fMRI studies in RBD have demonstrated early signatures of neurodegeneration across both motor and non-motor pathways. Although more work is needed, such findings have the potential to inform our understanding of disease, help to distinguish between prodromal PD and prodromal dementia with Lewy bodies, and support the development of fMRI-based outcome measures of phenoconversion and progression in future disease modifying trials. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":null,"pages":null},"PeriodicalIF":7.4000,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Movement Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mds.29898","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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Abstract
Neuroimaging studies in rapid eye movement sleep behavior disorder (RBD) can inform fundamental questions about the pathogenesis of Parkinson's disease (PD). Across modalities, functional magnetic resonance imaging (fMRI) may be better suited to identify changes between neural networks in the earliest stages of Lewy body diseases when structural changes may be subtle or absent. This review synthesizes the findings from all fMRI studies of RBD to gain further insight into the pathophysiology and progression of Lewy body diseases. A total of 32 studies were identified using a systematic review conducted according to PRISMA guidelines between January 2000 to February 2024 for original fMRI studies in patients with either isolated RBD (iRBD) or RBD secondary to PD. Common functional alterations were detectable in iRBD patients compared with healthy controls across brainstem nuclei, basal ganglia, frontal and occipital lobes, and whole brain network measures. Patients with established PD and RBD demonstrated decreased functional connectivity across the whole brain and brainstem nuclei, but increased functional connectivity in the cerebellum and frontal lobe compared with those PD patients without RBD. Finally, longitudinal changes in resting state functional connectivity were found to track with disease progression. Currently, fMRI studies in RBD have demonstrated early signatures of neurodegeneration across both motor and non-motor pathways. Although more work is needed, such findings have the potential to inform our understanding of disease, help to distinguish between prodromal PD and prodromal dementia with Lewy bodies, and support the development of fMRI-based outcome measures of phenoconversion and progression in future disease modifying trials. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
通过功能磁共振成像了解快速眼动睡眠行为障碍:系统回顾
快速眼动睡眠行为障碍(RBD)的神经影像学研究可以为帕金森病(PD)发病机制的基本问题提供信息。在各种模式中,功能磁共振成像(fMRI)可能更适合识别路易体疾病早期阶段神经网络之间的变化,因为此时结构变化可能很微妙或不存在。本综述综合了所有关于路易体疾病的 fMRI 研究结果,以进一步了解路易体疾病的病理生理学和进展。在2000年1月至2024年2月期间,我们根据PRISMA指南进行了系统性回顾,共确定了32项研究,这些研究是针对孤立RBD(iRBD)或继发于帕金森病的RBD患者进行的原始fMRI研究。与健康对照组相比,iRBD 患者在脑干核团、基底节、额叶和枕叶以及全脑网络测量方面均可检测到常见的功能改变。与没有RBD的帕金森病患者相比,已确诊的帕金森病和RBD患者在全脑和脑干核的功能连通性上有所下降,但在小脑和额叶的功能连通性上有所上升。最后,研究还发现静息状态功能连接性的纵向变化与疾病进展有关。目前,针对 RBD 的 fMRI 研究已显示出运动和非运动通路神经变性的早期特征。虽然还需要做更多的工作,但这些发现有可能帮助我们理解疾病,有助于区分前驱型帕金森病和前驱型路易体痴呆,并支持在未来的疾病调整试验中开发基于 fMRI 的表型转换和进展的结果测量。© 2024 The Author(s).运动障碍》由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版。
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