REM sleep behavior disorder in early Parkinson's disease predicts the rapid dopaminergic denervation. (November 2020)

• Record Type: Journal Article
• Authors: Kim, Young Eun; Kim, Yun Joong; Hwang, Hee Sung; Ma, Hyeo-il
• Is Part Of: Parkinsonism & related disorders. Volume 80(2020)
• Page Start: 120
• Page End: 126
• Publication Date: 2020-11
• Subjects: REM sleep Behavior disorder -- Parkinson's disease -- SPECT -- Prognosis -- PPMI; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2020.09.032
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Objective: To test the hypothesis that REM sleep behavior disorder (RBD) in early Parkinson's disease (PD) predicts rapid progression of dopaminergic denervation. Methods: 123I-FP-CIT single photon emission computed tomography (SPECT) scans were performed sequentially at baseline, 1 year, 2 years, and 4 years in 416 de novo patients with PD. RBD screening questionnaire scores >5 at baseline placed the participant in the likely-RBD group. Temporal changes in the specific binding ratio (SBR; caudate, putamen. sum of both, striatum) were compared between the likely-RBD and the non-likely-RBD groups for more or less affected striatum with a repeated measure ANOVA. Results: Likely-RBD was reported in 37.7% of the drug-naïve PD patients at baseline. The likely-RBD and non-likely-RBD groups did not have significant differences in the baseline clinical features including gender, age, disease duration, UPDRS motor score, and striatal SBR. Striatal SBR decreased significantly over four years in both groups (P < .001). In the analysis of a more affected striatum, striatal SBR decreased significantly faster in the likely-RBD group than in the non-likely-RBD group (P < .05 for all), whereas it was not statistically significant for the less affected striatum. The mean striatal SBR value (mean value of both striata), especially the caudate SBR, indicated greater acceleration of denervation in the likely-RBD group than in the non-likely-RBD group over time (P < .05). Conclusion: Likely-RBD in PD predicts accelerating dopaminergic denervation, thereby implicating it as a marker for a poor prognosis or distinctive subtype in PD. Highlights: RBD in early Parkinson's disease (PD) predicts rapid progression of dopaminergic denervation by 123I-FP-CIT SPECT for 4 years follow-up. Accelerating dopaminergic denervation regarding RBD in PD was observed in the more affected striatum, but not in the less affected striatum. Accelerating dopaminergic denervation regarding RBD in PD was prominent in the caudate, but not in the putamen.