快速眼动睡眠行为障碍--雷伊氏体病持续状态中β-淀粉样蛋白负荷对认知的影响。

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2024-10-14 DOI:10.1002/mds.30031

Kyung Ah Woo MD, PhD, Eun Jin Yoon PhD, Seoyeon Kim MD, Heejung Kim PhD, Ryul Kim MD, PhD, Bora Jin MD, Seungmin Lee MD, Hyunwoong Park MD, PhD, Hyunwoo Nam MD, PhD, Yu Kyeong Kim MD, PhD, Jee-Young Lee MD, PhD

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引用次数: 0

摘要

背景快速眼动睡眠行为障碍（RBD）与路易体病（LBD）的弥漫恶性亚型和较高的认知负担有关。目的本研究探讨了大脑β淀粉样蛋白沉积及其与RBD-LBD连续体认知能力下降的关系。方法患有孤立性路易体痴呆（iRBD）、帕金森病伴有可能的路易体痴呆（PDRBD）和路易体痴呆伴有可能的路易体痴呆（DLBRBD）的患者接受了18F-氟贝特宾正电子发射断层扫描、3T磁共振成像扫描和全面的神经心理学评估。受试者被分为认知正常（NC）、轻度认知障碍（MCI）或痴呆。通过对各认知组的体素进行比较分析，得出了预定的认知兴趣容积（VOI），即前额叶、顶叶、前中央皮层、舌回和辅助运动区，并估算了这些容积的整体和区域标准化摄取值比（SUVR）。广义线性模型评估了18F-氟贝特宾SUVR与神经心理测试之间的关系，并对年龄和性别进行了调整。亚组分析的重点是多导睡眠图证实的 iRBD 连续性亚组（n = 41），包括我们的前瞻性 iRBD 队列中的表型转换者和非转换者：14 名 NC 患者、54 名 MCI 患者和 18 名痴呆患者。β-淀粉样蛋白扫描阳性的比例随着认知阶段的加深而增加（P = 0.038）。认知 VOI 中的β-淀粉样蛋白信号在出现路径模拟测试 B（TMT-B）障碍的亚组中升高。在iRBD-连续性亚组中观察到TMT-B z得分与整体皮质β淀粉样蛋白水平之间存在线性关系（P = 0.013）。TMT-B表现可能是与β淀粉样蛋白负荷相关联的一个有用标记，尤其是在iRBD人群中。© 2024 作者。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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Cognitive Impact of β-Amyloid Load in the Rapid Eye Movement Sleep Behavior Disorder–Lewy Body Disease Continuum

Background

Rapid eye movement sleep behavior disorder (RBD) is linked to the diffuse-malignant subtype and higher cognitive burden in Lewy body disease (LBD).

Objective

This study explores brain β-amyloid deposition and its association with cognitive decline across the RBD–LBD continuum.

Methods

Patients with isolated RBD (iRBD), Parkinson's disease with probable RBD (PDRBD), and dementia with Lewy bodies with probable RBD (DLBRBD) underwent ¹⁸F-florbetaben positron emission tomography, 3T magnetic resonance imaging scans, and comprehensive neuropsychological assessments. Subjects were categorized as cognitively normal (NC), mild cognitive impairment (MCI), or dementia. Global and regional standardized uptake value ratios (SUVR) were estimated in predefined cognitive volumes of interest (VOI) derived from voxel-wise comparison analysis among the cognitive groups, namely the prefrontal, parietal, precentral cortices, lingual gyrus, and supplementary motor area. Generalized linear models assessed the relationship between ¹⁸F-florbetaben SUVRs and neuropsychological testing, adjusting for age and sex. Subgroup analysis focused on the polysomnography-confirmed iRBD-continuum subset (n = 41) encompassing phenoconverters and nonconverters in our prospective iRBD cohort.

Results

Eighty-six subjects were classified as follows: 14 NC, 54 MCI, and 18 dementia. The proportion of positive β-amyloid scans increased with advanced cognitive stages (P = 0.038). β-Amyloid signals in cognitive VOIs were elevated in subgroups showing impairment in Trail-Making Test B (TMT-B). A linear association between TMT-B z score and global cortical β-amyloid levels was observed in the iRBD-continuum subset (P = 0.013).

Conclusion

Cortical β-amyloid accumulates with declines in executive function within the RBD–LBD continuum. TMT-B performance may be a useful marker associating with β-amyloid load, particularly in the iRBD population. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.