Prefrontal network dysfunctions in rapid eye movement sleep behavior disorder

Noritaka Wakasugi; Hiroki Togo; Yohei Mukai; Noriko Nishikawa; Takashi Sakamoto; Miho Murata; Yuji Takahashi; Hiroshi Matsuda; Takashi Hanakawa

doi:10.1016/j.parkreldis.2021.03.005

Prefrontal network dysfunctions in rapid eye movement sleep behavior disorder

Parkinsonism Relat Disord. 2021 Apr:85:72-77. doi: 10.1016/j.parkreldis.2021.03.005. Epub 2021 Mar 13.

Authors

Noritaka Wakasugi¹, Hiroki Togo¹, Yohei Mukai², Noriko Nishikawa², Takashi Sakamoto², Miho Murata², Yuji Takahashi², Hiroshi Matsuda¹, Takashi Hanakawa³

Affiliations

¹ Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
² Department of Neurology, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan.
³ Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: hanakawa.takashi.2s@kyoto-u.ac.jp.

PMID: 33744693
DOI: 10.1016/j.parkreldis.2021.03.005

Abstract

Introduction: Resting-state functional connectivity magnetic resonance imaging (rsfcMRI) of rapid eye movement (REM) sleep behavior disorder (RBD) may provide an early biomarker of α-synucleinopathy. However, few rsfcMRI studies have examined cognitive networks. To elucidate brain network changes in RBD, we performed rsfcMRI in patients with polysomnography-confirmed RBD and healthy controls (HCs), with a sufficiently large sample size in each group.

Methods: We analyzed rsfcMRI data from 50 RBD patients and 70 age-matched HCs. Although RBD patients showed no motor signs, some exhibited autonomic and cognitive problems. Several resting-state functional networks were extracted by group independent component analysis from HCs, including the executive-control (ECN), default-mode (DMN), basal ganglia (BGN), and sensory-motor (SMN) networks. Functional connectivity (FC) was compared between groups using dual regression analysis. In the RBD group, correlation analysis was performed between FC and clinical/cognitive scales.

Results: Patients with RBD showed reduced striatal-prefrontal FC in ECN, consistent with executive dysfunctions. No abnormalities were found in DMN. In the motor networks, we identified reduced midbrain-pallidum FC in BGN and reduced motor and somatosensory cortex FC in SMN.

Conclusion: We found abnormal ECN and normal DMN as a possible hallmark of cognitive dysfunctions in early α-synucleinopathies. We replicated abnormalities in BGN and SMN corresponding to subclinical movement disorder of RBD. RsfcMRI may provide an early biomarker of both cognitive and motor network dysfunctions of α-synucleinopathies.

Keywords: Case control study; Functional MRI; Imaging biomarker; Parkinson's disease with dementia; REM sleep Behavior disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Case-Control Studies
Cognitive Dysfunction / etiology
Cognitive Dysfunction / physiopathology*
Connectome*
Executive Function / physiology*
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Nerve Net / diagnostic imaging
Nerve Net / physiopathology*
Prefrontal Cortex / diagnostic imaging
Prefrontal Cortex / physiopathology*
REM Sleep Behavior Disorder / complications
REM Sleep Behavior Disorder / diagnostic imaging
REM Sleep Behavior Disorder / physiopathology*