尾部低代谢是转化为帕金森病的风险因素,在孤立的REM睡眠行为障碍中
Giulia Carli1, Sanne K Meles2, Annette Janzen3
1Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. g.carli@umcg.nl.
概括
孤立的REM睡眠行为障碍 (iRBD) 患者在基线时部低代谢可能更早转化为帕金森病 (PD). 这一发现有助于为未来的疾病修饰性临床试验分层患者.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 孤立REM睡眠行为障碍 (iRBD) 是α-synucleinopathies的一个前兆阶段.
- 在iRBD中识别进展标志物对于预测神经退行变化和临床转化至关重要.
- 在iRBD中的纵向脑成像研究是有限的.
研究的目的:
- 为了研究iRBD患者区域大脑代谢的纵向变化,使用18F-FDG PET.
- 为了将这些大脑变化与临床综合征的现象转化相关联,例如帕金森病 (PD).
- 评估脑成像在预测神经退行症中的有用性.
主要方法:
- 20名iRBD患者经历了大约3.7年的18F-FDG PET扫描和临床评估.
- 基线123I-MIBG和123I-FP-CIT SPECT扫描对17名患者进行.
- 对18F-FDG PET数据进行了对照对象的分析,并检查了与PD相关模式 (PDRP) 评分的关系.
主要成果:
- 观察到18F-FDGPET变化的三个模式:正常扫描,尾/尾-尾低代谢的发展,或持续的尾低代谢.
- 患有基线部低代谢的患者 (N=6) 显示病理性SPECT扫描,并包括所有四个转换器到PD.
- 随着时间的推移,在额头和尾-尾区域的渐进性低代谢,以及小脑和边缘区域的高超代谢,都被注意到. 每年PDRP的z-score都会增加,主要是由于尾低代谢和小脑高代谢.
结论:
- 在iRBD的基线部低代谢表明短期转化为PD的可能性更高.
- 这些发现可能有助于患者在疾病修饰治疗试验中的分层.
- 18F-FDG PET可以作为监测iRBD神经退行性进展的宝贵工具.
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