J Mov Disord.
2019 May;12(2):103-112. 10.14802/jmd.18061.
Nonmotor and Dopamine Transporter Change in REM Sleep Behavior Disorder by Olfactory Impairment
- Affiliations
-
- 1Department of Neurology, Seoul National University–Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. wieber04@snu.ac.kr
- 2Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Nuclear Medicine, Seoul National University–Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. yk3181@snu.ac.kr
- 4Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea.
- 5Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 6Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea.
- 7Department of Neurology and Movement Disorders Center, Seoul National University Hospital, Seoul, Korea.
- KMID: 2449682
- DOI: http://doi.org/10.14802/jmd.18061
Abstract
OBJECTIVE
It is unclear whether the decline in dopamine transporters (DAT) differs among idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with different levels of olfactory impairment. This study aimed to characterize DAT changes in relation to nonmotor features in iRBD patients by olfactory loss.
METHODS
This prospective cohort study consisted of three age-matched groups: 30 polysomnography-confirmed iRBD patients, 30 drug-naïve Parkinson's disease patients, and 19 healthy controls without olfactory impairment. The iRBD group was divided into two groups based on olfactory testing results. Participants were evaluated for reported prodromal markers and then underwent 18F-FP-CIT positron emission tomography and 3T MRI. Tracer uptakes were analyzed in the caudate, anterior and posterior putamen, substantia nigra, and raphe nuclei.
RESULTS
Olfactory impairment was defined in 38.5% of iRBD patients. Mild parkinsonian signs and cognitive functions were not different between the two iRBD subgroups; however, additional prodromal features, constipation, and urinary and sexual dysfunctions were found in iRBD patients with olfactory impairment but not in those without. Tracer uptake showed significant group differences in all brain regions, except the raphe nuclei. The iRBD patients with olfactory impairment had uptake reductions in the anterior and posterior putamen, caudate, and substantia nigra (p < 0.016 in all, adjusted for age), which ranged from 0.6 to 0.8 of age-normative values. In contrast, those without olfactory impairment had insignificant changes in all regions ranging above 0.8.
CONCLUSION
There was a clear distinction in DAT loss and nonmotor profiles by olfactory status in iRBD.
Keyword
MeSH Terms
-
Brain
Cognition
Cohort Studies
Constipation
Dopamine Plasma Membrane Transport Proteins*
Dopamine*
Humans
Magnetic Resonance Imaging
Parkinson Disease
Positron-Emission Tomography
Prospective Studies
Putamen
Raphe Nuclei
REM Sleep Behavior Disorder*
Sleep, REM*
Smell
Substantia Nigra
Dopamine
Dopamine Plasma Membrane Transport Proteins
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- A Review on Sleep Disorders Similar to REM Sleep Behavior Disorder
- Clinical Biomarkers of Neurodegeneration in REM Sleep Behavior Disorder
- REM Sleep Behavior Disorder and Nightmares
- Two Cases of REM Sleep Behavior Disorder Combined with Severe Obstructive Sleep Apnea: Misdiagnosed as "Pseudo-REM Sleep Behavior Disorder" by Diagnostic Polysomnography
- A Patient with Obstructive Sleep Apnea Syndrome Presenting with REM Sleep Behavior Disorder Mimicking Symptoms
