Celine Haddad, Véronique Daneault, Violette Ayral, Marie Filiatrault, Alexandre Pastor-Bernier, Christina Tremblay, Arnaud Boré, Maxime Descoteaux, Andrew Vo, Jean-François Gagnon, Ronald B. Postuma, Petr Dusek, Stanislav Marecek, Zsoka Varga, Johannes Klein, Michele T. Hu, Stéphane Lehéricy, Isabelle Arnulf, Marie Vidailhet, Jean-Christophe Corvol, ICEBERG Study Group, Shady Rahayel
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Brain biomarkers predicting specific phenoconversion trajectories are lacking.</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>In this multicenter diffusion magnetic resonance imaging study (261 iRBD, 177 controls), free water (FW) was measured in the nucleus basalis of Meynert (NBM) and posterior substantia nigra (SN). Among 230 iRBD patients with follow-up, 64 converted (16 DLB, 38 PD). Time-to-event analyses were performed to assess differential phenoconversion.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>Phenoconverters had higher FW in the NBM and posterior SN. Only FW in the NBM predicted conversion to DLB over PD. NBM volume predicted DLB conversion, but only FW remained significant when both were modeled. FW in the NBM correlated with lower MoCA scores in iRBD.</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>FW in the NBM is a sensitive biomarker of cognitive decline and DLB progression in iRBD, outperforming volume and supporting its use in early stratification.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>FW in the NBM specifically identifies conversion to DLB.</li>\n \n <li>Increased FW in the NBM is associated with lower global cognition in iRBD.</li>\n \n <li>FW in the SN in iRBD does not relate more to DLB than PD.</li>\n \n <li>FW in the NBM is a biomarker of differential phenoconversion in iRBD.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 9","pages":""},"PeriodicalIF":11.1000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70570","citationCount":"0","resultStr":"{\"title\":\"Free water predicts dementia with Lewy bodies in isolated REM sleep behavior disorder\",\"authors\":\"Celine Haddad, Véronique Daneault, Violette Ayral, Marie Filiatrault, Alexandre Pastor-Bernier, Christina Tremblay, Arnaud Boré, Maxime Descoteaux, Andrew Vo, Jean-François Gagnon, Ronald B. Postuma, Petr Dusek, Stanislav Marecek, Zsoka Varga, Johannes Klein, Michele T. Hu, Stéphane Lehéricy, Isabelle Arnulf, Marie Vidailhet, Jean-Christophe Corvol, ICEBERG Study Group, Shady Rahayel\",\"doi\":\"10.1002/alz.70570\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> INTRODUCTION</h3>\\n \\n <p>Most individuals with isolated rapid eye movement sleep behavior disorder (iRBD) develop dementia with Lewy bodies (DLB) or Parkinson's disease (PD). Brain biomarkers predicting specific phenoconversion trajectories are lacking.</p>\\n </section>\\n \\n <section>\\n \\n <h3> METHODS</h3>\\n \\n <p>In this multicenter diffusion magnetic resonance imaging study (261 iRBD, 177 controls), free water (FW) was measured in the nucleus basalis of Meynert (NBM) and posterior substantia nigra (SN). Among 230 iRBD patients with follow-up, 64 converted (16 DLB, 38 PD). 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Free water predicts dementia with Lewy bodies in isolated REM sleep behavior disorder
INTRODUCTION
Most individuals with isolated rapid eye movement sleep behavior disorder (iRBD) develop dementia with Lewy bodies (DLB) or Parkinson's disease (PD). Brain biomarkers predicting specific phenoconversion trajectories are lacking.
METHODS
In this multicenter diffusion magnetic resonance imaging study (261 iRBD, 177 controls), free water (FW) was measured in the nucleus basalis of Meynert (NBM) and posterior substantia nigra (SN). Among 230 iRBD patients with follow-up, 64 converted (16 DLB, 38 PD). Time-to-event analyses were performed to assess differential phenoconversion.
RESULTS
Phenoconverters had higher FW in the NBM and posterior SN. Only FW in the NBM predicted conversion to DLB over PD. NBM volume predicted DLB conversion, but only FW remained significant when both were modeled. FW in the NBM correlated with lower MoCA scores in iRBD.
DISCUSSION
FW in the NBM is a sensitive biomarker of cognitive decline and DLB progression in iRBD, outperforming volume and supporting its use in early stratification.
Highlights
FW in the NBM specifically identifies conversion to DLB.
Increased FW in the NBM is associated with lower global cognition in iRBD.
FW in the SN in iRBD does not relate more to DLB than PD.
FW in the NBM is a biomarker of differential phenoconversion in iRBD.
期刊介绍：
Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.
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