한빛사논문
- 조회246
서울대학교 의과대학
Eun Jin Yoon, PhD1, 2*; Jee-Young Lee, MD, PhD3*; Heejung Kim, PhD2, 4; Dallah Yoo, MD3, 5; Jung Hwan Shin, MD, PhD3; Hyunwoo Nam, MD, PhD3; Beomseok Jeon, MD, PhD6; Yu Kyeong Kim, MD, PhD2
1. Memory Network Medical Research Center, Seoul National University, Seoul, Korea, Republic of; 2. Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of; 3. Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of; 4. Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea, Republic of; 5. Department of Neurology, Kyung Hee University Hospital, Seoul, Korea, Republic of; 6. Department of Neurology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea, Republic of
*These authors contributed equally as co-first authors
Corresponding Author: Yu Kyeong Kim
Abstract
Background and Objectives Mild cognitive impairment (MCI) in isolated REM sleep behavior disorder (iRBD) is a risk factor for subsequent neurodegeneration. We aimed to identify brain metabolism and functional connectivity changes related to MCI in patients with iRBD and the neuroimaging markers' predictive value for phenoconversion.
Methods This is a prospective cohort study of patients with iRBD with a mean follow-up of 4.2 ± 2.6 years. At baseline, patients with iRBD and age- and sex-matched healthy controls (HCs) underwent 18F-fluorodeoxyglucose (FDG)–PET and resting-state fMRI scans and a comprehensive neuropsychological test battery. Voxel-wise group comparisons for FDG-PET data were performed using a general linear model. Seed-based connectivity maps were computed using brain regions showing significant hypometabolism associated with MCI in patients with iRBD and compared between groups. A Cox regression analysis was applied to investigate the association between brain metabolism and risk of phenoconversion.
Results Forty patients with iRBD, including 21 with MCI (iRBD-MCI) and 19 with normal cognition (iRBD-NC), and 24 HCs were included in the study. The iRBD-MCI group revealed relative hypometabolism in the inferior parietal lobule, lateral and medial occipital, and middle and inferior temporal cortex bilaterally compared with HC and the iRBD-NC group. In seed-based connectivity analyses, the iRBD-MCI group exhibited decreased functional connectivity of the left angular gyrus with the occipital cortex. Of 40 patients with iRBD, 12 patients converted to Parkinson disease (PD) or dementia with Lewy bodies (DLB). Hypometabolism of the occipital pole (hazard ratio [95% CI] 6.652 [1.387–31.987]), medial occipital (4.450 [1.143–17.327]), and precuneus (3.635 [1.009–13.093]) was associated with higher phenoconversion rate to PD/DLB.
Discussion MCI in iRBD is related to functional and metabolic changes in broad brain areas, particularly the occipital and parietal areas. Moreover, hypometabolism in these brain regions was a predictor of phenoconversion to PD or DLB. Evaluation of cognitive function and neuroimaging characteristics could be useful for risk stratification in patients with iRBD.
논문정보
- Research article
- 2022년 04월 (BRIC 등록일 2022-11-01)
- 국내 연구진
- 바이오·의료융합 > 뇌인지과학
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