帕金森病伴快速眼动睡眠行为障碍的白质变性范围更广、速度更快。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-02-01 DOI:10.1016/j.sleep.2024.12.001

Sijia Tan , Jiaqi Wen , Jianmei Qin , Xiaojie Duanmu , Chenqing Wu , Weijin Yuan , Qianshi Zheng , Tao Guo , Cheng Zhou , Haoting Wu , Jingwen Chen , Jingjing Wu , Hui Hong , Bingting Zhu , Yuelin Fang , Yaping Yan , Baorong Zhang , Minming Zhang , Xiaojun Guan , Xiaojun Xu

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引用次数: 0

摘要

背景：在帕金森病（PD）中，快速眼动（REM）睡眠行为障碍（RBD）预示着较差的预后，但其对白质（WM）变性的影响尚不清楚。该研究检查了RBD对PD进展中WM改变的影响。方法：研究纳入45例可能存在RBD的PD患者（PD- prbd）、38例不存在RBD的PD患者（PD- nprbd）和79例健康对照（HC）。所有患者每年至少进行一次临床评估和弥散性MRI扫描，最多4次。79例HC在基线时接受了相同的治疗方案。WM指标包括分数各向异性（FA）、平均扩散率（MD）、径向扩散率（RD）和轴向扩散率（AD），采用基于束的空间统计方法计算。采用线性混合效应模型来观察临床特征和WM纤维的变化。结果:基线,PD-npRBD显示增加RD在几个地区,主要在双边钩状的纤维束(UF)伪劣纵束董继玲女士相比,HC (PFDRFDRFDRFDRConclusions: PD患者pRBD演示更广泛的WM变性和加速退化在左董继玲女士和疾病过程中佛罗里达大学。然而，由于缺乏PSG验证，这些结果在与RBD直接相关时应谨慎解释。这些发现为RBD对PD进展的潜在影响相关的神经结构基础提供了新的见解。

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Wider and faster degeneration of white matter in Parkinson's disease with possible REM sleep behaviour disorder

Background

In Parkinson's disease (PD), rapid eye movement (REM) sleep behaviour disorder (RBD) signifies a poorer prognosis, yet its impact on white matter (WM) degeneration remains unclear. The study examined the effect of RBD on WM alterations in PD progression.

Methods

The study included 45 PD patients with possible RBD (PD-pRBD), 38 PD patients without possible RBD (PD-npRBD), and 79 healthy controls (HC). All patients underwent clinical assessments and diffusion MRI scans at least once a year for up to 4 visits. 79 HC underwent the same protocol at baseline. WM metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were calculated using tract-based spatial statistics. Linear mixed-effects models were conducted to examine the changes in clinical features and WM fibers.

Results

At baseline, PD-npRBD showed increased RD in several regions, predominantly in bilateral uncinate fasciculus (UF) and inferior longitudinal fasciculus (ILF), compared to HC (P_FDR<0.05). During follow-up, PD-npRBD had further FA decrease in left UF and ILF (P_FDR<0.05). PD-pRBD showed reduced FA in several regions relative to HC at baseline (P_FDR<0.05), and faster FA decline in left UF and ILF than PD-npRBD during follow-up, with more extensive FA decrease in other regions such as anterior thalamic radiation and inferior fronto-occipital fasciculus (P_FDR<0.05). Moreover, increased RD in the left corticospinal tract correlated with motor symptoms (p = 0.045) in PD-pRBD.

Conclusions

PD patients with pRBD demonstrated more extensive WM degeneration and accelerated degeneration in the left ILF and UF during the disease course. However, due to the lack of PSG verification, these results should be interpreted cautiously while directly relating to RBD. These findings provide new insights into the neural structural basis associated with the potential impact of RBD on PD progression.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.