Abstract
Background/Objective: Idiopathic REM sleep behavior disorder (iRBD) often precedes Parkinson's disease (PD) and other alpha-synucleinopathies. The aim of the study is to investigate brain glucose metabolism of patients with RBD and PD by means of a multidimensional scaling approach, using18F-FDG-PET as a biomarker of synaptic function. Methods: Thirty-six iRBD patients (64.1±6.5 y, 32 M), 72 PD patients, and 79 controls (65.6±9.4 y, 53 M) underwent brain 18 F-FDG-PET. PD patients were divided according to the absence (PD, 32 subjects; 68.4±8.5 y, 15 M) or presence (PDRBD, 40 subjects; 71.8±6.6 y, 29 M) of RBD. 18F-FDG-PET scans were used to independently discriminate subjects belonging to four categories: Controls (RBD no, PD no), iRBD (RBD yes, PD no), PD (RBD no, PD yes) and PDRBD (RBD yes, PD yes). Results: The discriminant analysis was moderately accurate in identifying the correct category. This is because the model mostly confounds iRBD and PD, thus the intermediate classes. Indeed, iRBD, PD and PDRBD were progressively located at increasing distance from controls and are ordered along a single dimension (principal coordinate analysis) indicating the presence of a single flux of variation encompassing both RBD and PD conditions. Conclusion: Data-driven approach to brain 18 F-FDG-PET showed only moderate discrimination between iRBD and PD patients, highlighting brain glucose metabolism heterogeneity among such patients. iRBD should be considered as a marker of an ongoing condition that may be picked-up in different stages across patients and thus express different brain imaging features and likely different clinical trajectories.
| Language | English |
|---|---|
| Pages | 229-239 |
| Number of pages | 11 |
| Journal | Journal of Parkinson's Disease |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| State | Published - 1 Jan 2019 |
Keywords
- F-FDG-PET
- Parkinson's disease
- REM sleep behavior disorder
- synucleinopathy
Cite this
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Brain glucose metabolism heterogeneity in idiopathic REM sleep behavior disorder and in Parkinson's disease. / Arnaldi, Dario (Corresponding author); Meles, Sanne K.; Giuliani, Alessandro; Morbelli, Silvia; Renken, Remco J.; Janzen, Annette; Sittig-Wiegand, Elisabeth; Depboylu, Candan; Reetz, Kathrin; Overeem, Sebastiaan; Pijpers, Angelique; Reesink, Fransje E.; Van Laar, Teus; Teune, Laura K.; Höffken, Helmut; Luster, Marcus; Timmermann, Lars; Kesper, Karl; Adriaanse, Sofie M.; Booij, Jan; Sambuceti, Gianmario; Girtler, Nicola.
In: Journal of Parkinson's Disease, Vol. 9, No. 1, 01.01.2019, p. 229-239.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Brain glucose metabolism heterogeneity in idiopathic REM sleep behavior disorder and in Parkinson's disease
AU - Arnaldi,Dario
AU - Meles,Sanne K.
AU - Giuliani,Alessandro
AU - Morbelli,Silvia
AU - Renken,Remco J.
AU - Janzen,Annette
AU - Sittig-Wiegand,Elisabeth
AU - Depboylu,Candan
AU - Reetz,Kathrin
AU - Overeem,Sebastiaan
AU - Pijpers,Angelique
AU - Reesink,Fransje E.
AU - Van Laar,Teus
AU - Teune,Laura K.
AU - Höffken,Helmut
AU - Luster,Marcus
AU - Timmermann,Lars
AU - Kesper,Karl
AU - Adriaanse,Sofie M.
AU - Booij,Jan
AU - Sambuceti,Gianmario
AU - Girtler,Nicola
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background/Objective: Idiopathic REM sleep behavior disorder (iRBD) often precedes Parkinson's disease (PD) and other alpha-synucleinopathies. The aim of the study is to investigate brain glucose metabolism of patients with RBD and PD by means of a multidimensional scaling approach, using18F-FDG-PET as a biomarker of synaptic function. Methods: Thirty-six iRBD patients (64.1±6.5 y, 32 M), 72 PD patients, and 79 controls (65.6±9.4 y, 53 M) underwent brain 18 F-FDG-PET. PD patients were divided according to the absence (PD, 32 subjects; 68.4±8.5 y, 15 M) or presence (PDRBD, 40 subjects; 71.8±6.6 y, 29 M) of RBD. 18F-FDG-PET scans were used to independently discriminate subjects belonging to four categories: Controls (RBD no, PD no), iRBD (RBD yes, PD no), PD (RBD no, PD yes) and PDRBD (RBD yes, PD yes). Results: The discriminant analysis was moderately accurate in identifying the correct category. This is because the model mostly confounds iRBD and PD, thus the intermediate classes. Indeed, iRBD, PD and PDRBD were progressively located at increasing distance from controls and are ordered along a single dimension (principal coordinate analysis) indicating the presence of a single flux of variation encompassing both RBD and PD conditions. Conclusion: Data-driven approach to brain 18 F-FDG-PET showed only moderate discrimination between iRBD and PD patients, highlighting brain glucose metabolism heterogeneity among such patients. iRBD should be considered as a marker of an ongoing condition that may be picked-up in different stages across patients and thus express different brain imaging features and likely different clinical trajectories.
AB - Background/Objective: Idiopathic REM sleep behavior disorder (iRBD) often precedes Parkinson's disease (PD) and other alpha-synucleinopathies. The aim of the study is to investigate brain glucose metabolism of patients with RBD and PD by means of a multidimensional scaling approach, using18F-FDG-PET as a biomarker of synaptic function. Methods: Thirty-six iRBD patients (64.1±6.5 y, 32 M), 72 PD patients, and 79 controls (65.6±9.4 y, 53 M) underwent brain 18 F-FDG-PET. PD patients were divided according to the absence (PD, 32 subjects; 68.4±8.5 y, 15 M) or presence (PDRBD, 40 subjects; 71.8±6.6 y, 29 M) of RBD. 18F-FDG-PET scans were used to independently discriminate subjects belonging to four categories: Controls (RBD no, PD no), iRBD (RBD yes, PD no), PD (RBD no, PD yes) and PDRBD (RBD yes, PD yes). Results: The discriminant analysis was moderately accurate in identifying the correct category. This is because the model mostly confounds iRBD and PD, thus the intermediate classes. Indeed, iRBD, PD and PDRBD were progressively located at increasing distance from controls and are ordered along a single dimension (principal coordinate analysis) indicating the presence of a single flux of variation encompassing both RBD and PD conditions. Conclusion: Data-driven approach to brain 18 F-FDG-PET showed only moderate discrimination between iRBD and PD patients, highlighting brain glucose metabolism heterogeneity among such patients. iRBD should be considered as a marker of an ongoing condition that may be picked-up in different stages across patients and thus express different brain imaging features and likely different clinical trajectories.
KW - F-FDG-PET
KW - Parkinson's disease
KW - REM sleep behavior disorder
KW - synucleinopathy
UR - http://www.scopus.com/inward/record.url?scp=85061206299&partnerID=8YFLogxK
U2 - 10.3233/JPD-181468
DO - 10.3233/JPD-181468
M3 - Article
VL - 9
SP - 229
EP - 239
JO - Journal of Parkinson's Disease
T2 - Journal of Parkinson's Disease
JF - Journal of Parkinson's Disease
SN - 1877-7171
IS - 1
ER -