한빛사논문
- 조회539
Jung Hwan Shin, MD, PhD, Jee-Young Lee, MD, PhD, Yu-Kyeong Kim, MD, PhD, Eun Jin Yoon, PhD, Heejung Kim, PhD, Hyunwoo Nam, MD, PhD and Beomseok Jeon, MD, PhD
From the Department of Neurology (J.H.S., J.-Y.L., H.N.), Seoul Metropolitan Government--Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Department of Nuclear Medicine (Y.-K.K., E.J.Y., H.K.), Seoul Metropolitan Government--Seoul National University Boramae Medical Center; Institute of Radiation Medicine (H.K.), Medical Research Center, Seoul National University; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea.
Correspondence Dr. Lee or Dr. Yu-Kyeong Kim
Abstract
Objective To elucidate the role of Parkinson disease (PD)-related brain metabolic patterns as a biomarker in isolated REM sleep behavior disorder (iRBD) for future disease conversion.
Methods This is a prospective cohort study consisting of 30 patients with iRBD, 25 patients with de novo PD with a premorbid history of RBD, 21 patients with longstanding PD on stable treatment, and 24 healthy controls. The iRBD group was longitudinally followed up. All participants underwent 18F-fluorodeoxyglucose (FDG) PET and were evaluated with olfaction, cognition, and the Movement Disorders Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) at baseline. From FDG-PET scans, we derived metabolic patterns from the longstanding PD group (PD-RP) and de novo PD group with RBD (dnPDRBD-RP). Subsequently, we calculated the PD-RP and dnPDRBD-RP scores in patients with iRBD. We validated the metabolic patterns in each PD group and separate iRBD cohort (n = 14).
Results The 2 patterns significantly correlated with each other and were spatially overlapping yet distinct. The MDS-UPDRS motor scores significantly correlated with PD-RP (p = 0.013) but not with dnPDRBD-RP (p = 0.076). In contrast, dnPDRBD-RP correlated with olfaction in butanol threshold test (p = 0.018) in patients with iRBD, but PD-RP did not (p = 0.21). High dnPDRBD-RP in patients with iRBD predicted future phenoconversion with all cutoff ranges from 1.5 to 3 SD of the control value, whereas predictability of PD-RP was only significant in a partial range of cutoff.
Conclusion The dnPDRBD-RP is an efficient neuroimaging biomarker that reflects prodromal features of PD and predicts phenoconversion in iRBD that can be applied individually.
Classification of Evidence This study provides Class IV evidence that a de novo PD pattern on FDG-PET predicts future conversion to neurodegenerative disease in patients with iRBD.
논문정보
- Research article
- 2021년 07월 (BRIC 등록일 2021-09-10)
- 국내 연구진
- 바이오·의료융합 > 뇌인지과학
관련 웨비나
![파킨슨병의 뇌대사패턴 바이오마커의 전구 단계 파킨슨병에서의 활용 [Neurology]](/upload/board/files/onseminar/thumb/thumb_0000349.png)
학술웨비나
파킨슨병의 뇌대사패턴 바이오마커의 전구 단계 파킨슨병에서의 활용 [Neurology] 렘수면행동장애는 파킨슨병을 비롯한 시누클레인이 침착되는 뇌퇴행성 질환의 전구단계로 알려져 있습니다. 15년이상의 추적 관찰 연구 결과, 80%이상의 렘수면행동장애 환자들이 파킨슨병, 루이소체치매, 다계통 위축증이 발현됩니다. 따라서 이러한 렘수면행동장애 환자들 중 빠른 시일내에 질병 발생을 예측할 수 있는 바이오마커를 개발하는 것이 필수적이며, 특히 추후 임상시험을 계획할때, 객관적이고 믿을수 있는 바이오마커가 반드시 필요합니다. 본 연구에서는 렘수면행동장애를 동반한 파킨슨병 환자에게서 뇌대사패턴을 추출하였습니다. 이 패턴은 특징적인 파킨슨병의 전구단계 임상특징을 반영하였고, 추후 질병 발생을 유의하게 예측할 수 있음을 보였습니다. 가장 큰 장점으로는 이 패턴을 이를 개인에게 적용할수 있기에 실제 임상에서 환자의 증상을 모니터하고 예후를 예측하는데 유용하게 사용할 수 있습니다.- 신정환(서울대학교병원)
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