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Brain MRI Detection of an Abnormal Peak Width of Skeletonized Mean Diffusivity in REM Sleep Behavior Disorder
Dong Ah Lee1, Ho-Joon Lee2, Kang Min Park1
1Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Background And Purpose:
Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white matter damage in patients with isolated rapid eye movement sleep behavior disorder (RBD) using PSMD.
Methods:
We enrolled patients with newly diagnosed isolated RBD confirmed by polysomnography and age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was conducted using a 3-Tesla MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the Functional Magnetic Resonance Imaging of the Brain Software Library program. We compared the incidence of PSMD between patients with RBD and healthy controls and performed a correlation analysis between PSMD and clinical factors in patients with RBD.
Results:
Thirty patients with isolated RBD and 41 healthy controls were enrolled. The PSMD was significantly higher in patients with RBD than that in the healthy controls (3.078 vs. 2.746 × 10-4 mm2/s, p = 0.001). In addition, PSMD positively correlated with age in patients with RBD (r = 0.477, p = 0.007). However, PSMD was not associated with other clinical or polysomnographic factors.
Conclusion:
Patients with isolated RBD had a higher PSMD than healthy controls, indicating the evidence of white matter damage in patients with RBD. This finding highlights the potential of PSMD as a marker for detecting white matter damage, which may be related to small vessel diseases, in patients with sleep disorders.
Insights
Patients with isolated rapid eye movement sleep behavior disorder (RBD) exhibit white matter damage, as indicated by elevated Peak Width of Skeletonized Mean Diffusivity (PSMD). This suggests PSMD may detect early neurological changes in sleep disorders.
Area of Science:
- Neurology
- Sleep Medicine
- Neuroimaging
Background:
- Rapid eye movement sleep behavior disorder (RBD) is a neurodegenerative disease.
- White matter damage is a potential indicator of neurological dysfunction.
- Peak Width of Skeletonized Mean Diffusivity (PSMD) is a novel marker for white matter integrity.
Purpose of the Study:
- To investigate white matter damage in patients with isolated RBD.
- To evaluate the utility of PSMD as a marker for white matter integrity in RBD.
- To explore the relationship between PSMD and clinical factors in RBD patients.
Main Methods:
- Diffusion Tensor Imaging (DTI) was performed on 30 patients with isolated RBD and 41 healthy controls.
- PSMD was calculated using DTI data and histogram analysis.
- Correlation analysis was conducted between PSMD and clinical/polysomnographic factors.
Main Results:
- Patients with isolated RBD showed significantly higher PSMD compared to healthy controls.
- PSMD positively correlated with age in patients with RBD.
- No significant association was found between PSMD and other clinical or polysomnographic factors.
Conclusions:
- Isolated RBD is associated with white matter damage, as evidenced by elevated PSMD.
- PSMD shows potential as a sensitive marker for detecting white matter abnormalities in RBD.
- These findings suggest a link between RBD, white matter damage, and potentially small vessel disease.
