当前位置： SCI文献检索 > SLEEP MEDICINE期刊下所有文献 > Clinical markers of early nigrostriatal neurodegeneration in idiopathic rapid eye movement sleep behavior disorder.

Clinical markers of early nigrostriatal neurodegeneration in idiopathic rapid eye movement sleep behavior disorder.

Abstract：

BACKGROUND:Rapid eye movement sleep behavior disorder (RBD) is an early feature in α synucleinopathies and may precede other clinical manifestations of disease for several years. Olfactory dysfunction and mild motor abnormalities (MMAs) are highly prevalent in prodromal α synucleinopathies such as RBD and are suspected to be predictive neurodegenerative markers. Because both markers also are highly prevalent in the healthy elderly population, the discriminative value to detect an early neurodegenerative process is unclear. METHODS:We examined 28 patients with idiopathic RBD (iRBD) without manifest neurodegenerative disease to determine diagnostic accuracy of MMAs and olfactory dysfunction in identifying patients with early nigrostriatal degeneration in transcranial sonography (TCS) and (123)I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single-photon emission computed tomography ((123)I-FP-CIT-SPECT). RESULTS:Sixty-three percent of our participants showed MMAs which were strongly associated with abnormal TCS and (123)I-FP-CIT-SPECT findings. The discriminative value in detecting participants with early nigrostriatal degeneration was excellent (area under the receiver operating characteristic [ROC] curve, 0.84 [P≤.003] for TCS and 0.79 [P≤.066] for (123)I-FP-CIT-SPECT). Olfactory dysfunction was present in 78% of iRBD participants, but it was not linked with neuroimaging abnormalities or MMAs. Olfactory dysfunction did not discriminate participants with early nigrostriatal degeneration (area under the ROC curve, 0.54 [P≤.747] for TCS and 0.31 [P≤.225] for (123)I-FP-CIT-SPECT). Early RBD manifestation but no demographic (e.g., age, gender) or clinical characteristics of RBD (e.g., duration, severity of RBD) were associated with neuroimaging abnormalities in TCS and (123)I-FP-CIT-SPECT. CONCLUSIONS:Unlike olfactory dysfunction, MMAs discriminate patients with early nigrostriatal degeneration in iRBD. Early RBD manifestation seems to be an additional risk factor which aggravates neurodegenerative risk.

journal_name

Sleep Med

journal_title

Sleep medicine

authors

Rupprecht S,Walther B,Gudziol H,Steenbeck J,Freesmeyer M,Witte OW,Günther A,Schwab M

doi

10.1016/j.sleep.2013.06.008

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1064-70

issue

eissn

1389-9457

issn

1878-5506

pii

S1389-9457(13)00230-X

journal_volume

pub_type

杂志文章

在线工具

Clinical markers of early nigrostriatal neurodegeneration in idiopathic rapid eye movement sleep behavior disorder.