Longitudinal Changes in Isolated Rapid Eye Movement Sleep Behavior Disorder-Related Metabolic Pattern Expression
Ryul Kim1,2, Jee-Young Lee2, Yu Kyeong Kim3
1Department of Neurology, Inha University Hospital, Incheon, South Korea.
Summary
The metabolic pattern in isolated rapid eye movement sleep behavior disorder (iRBD) decreases over time, indicating disease progression. Baseline metabolic patterns do not reliably predict conversion, suggesting complex compensatory mechanisms in the brain.
Area of Science:
- Neuroscience
- Metabolic Imaging
- Sleep Medicine
Background:
- The metabolic pattern associated with isolated rapid eye movement sleep behavior disorder (iRBD) and its changes over time are not well understood.
- Understanding these changes is crucial for tracking disease progression in iRBD.
Purpose of the Study:
- To longitudinally assess changes in the iRBD-related metabolic pattern (RBDRP) in iRBD patients.
- To investigate the metabolic activity trajectories of specific brain regions within the RBDRP.
Main Methods:
- A cohort study included 25 iRBD patients and 24 healthy controls.
- 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans were performed at baseline and 2- or 4-year follow-ups.
- RBDRP expression was measured and validated in a separate iRBD cohort.
Main Results:
- Baseline RBDRP expression distinguished iRBD patients from controls.
- RBDRP expression z-scores decreased over time in iRBD patients, even in those at high risk of phenoconversion.
- Decreased frontal cortex metabolism and increased occipital cortex metabolism, along with rising putaminal activity, characterized disease progression.
Conclusions:
- RBDRP expression significantly alters over time in iRBD patients, reflecting disease progression.
- Observed metabolic changes may represent compensatory mechanisms against neurodegeneration.
- Single-time-point RBDRP measurements are not reliable predictors of disease conversion.
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