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Related Concept Videos

REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

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REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
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Sleep progresses through distinct stages, each characterized by specific brain wave patterns and physiological responses ranging from wakefulness to stages of non-rapid eye movement, known as non-REM, to rapid eye movement, referred to as REM. Understanding these stages helps in recognizing how sleep supports various bodily and cognitive functions.
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Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
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Sleepwalking and Sleep Talking01:17

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Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
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Distinct brain atrophy progression subtypes underlie phenoconversion in isolated REM sleep behaviour disorder.

Stephen Joza1, Aline Delva2, Christina Tremblay3

  • 1The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, H3A 2B4, Canada; Division of Neurology, Department of Medicine, and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada.

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Summary

Two brain atrophy progression subtypes exist in synucleinopathies like idiopathic REM sleep behavior disorder (iRBD). The cortical-first subtype increases dementia with Lewy bodies (DLB) risk, while both worsen motor symptoms.

Keywords:
Dementia with Lewy bodiesMRIMachine learningParkinson's diseaseREM sleep behaviour disorderSubtyping

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Area of Science:

  • Neuroscience
  • Neurology
  • Medical Imaging

Background:

  • Synucleinopathies, including idiopathic REM sleep behavior disorder (iRBD), Parkinson's disease (PD), and dementia with Lewy bodies (DLB), present with diverse clinical features.
  • Brain atrophy patterns are observable in iRBD, but the initiation and progression of atrophy remain incompletely understood.

Purpose of the Study:

  • To investigate and characterize the spatiotemporal patterns of brain atrophy progression in synucleinopathies.
  • To identify distinct subtypes of atrophy progression and their clinical implications.

Main Methods:

  • Utilized a multicentric cohort of 1276 participants (iRBD, PD with RBD, DLB, controls) with T1-weighted MRI and longitudinal assessments.
  • Employed vertex-based cortical surface reconstruction and volumetric segmentation for atrophy quantification.
  • Applied the Subtype and Stage Inference (SuStaIn) algorithm to model atrophy progression patterns.

Main Results:

  • Identified two distinct atrophy progression subtypes: 'cortical-first' (frontal lobe onset) and 'subcortical-first' (limbic onset).
  • Both subtypes showed increased motor symptom progression (MDS-UPDRS-III); cognitive decline was linked to advancing stages in the cortical-first subtype.
  • Patients classified into subtypes were more likely to phenoconvert; iRBD patients in the cortical-first subtype had a higher likelihood of developing DLB compared to PD.

Conclusions:

  • Two distinct brain atrophy progression subtypes exist in iRBD.
  • The cortical-first subtype is associated with an increased risk of developing dementia with Lewy bodies (DLB).
  • Both identified subtypes correlate with worsening parkinsonian motor features, suggesting utility in disease monitoring and clinical trial stratification.