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Dopaminergic imaging and clinical predictors for phenoconversion of REM sleep behaviour disorder
D. Arnaldi, A. Chincarini, MT. Hu, K. Sonka, B. Boeve, T. Miyamoto, M. Puligheddu, VC. De Cock, M. Terzaghi, G. Plazzi, N. Tachibana, S. Morbelli, M. Rolinski, P. Dusek, V. Lowe, M. Miyamoto, M. Figorilli, D. Verbizier, I. Bossert, E. Antelmi, R....
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
Grantová podpora
J-0901
Parkinson's UK - United Kingdom
MC_EX_MR/N50192X/1
Medical Research Council - United Kingdom
MR/L023784/1
Medical Research Council - United Kingdom
MR/M024962/1
Medical Research Council - United Kingdom
NLK
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
PubMed
33348363
DOI
10.1093/brain/awaa365
Knihovny.cz E-zdroje
- MeSH
- jednofotonová emisní výpočetní tomografie MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- nucleus caudatus diagnostické zobrazování metabolismus MeSH
- porucha chování v REM spánku diagnostické zobrazování metabolismus MeSH
- proteiny přenášející dopamin přes plazmatickou membránu metabolismus MeSH
- putamen diagnostické zobrazování metabolismus MeSH
- retrospektivní studie MeSH
- ROC křivka MeSH
- senioři MeSH
- synukleinopatie diagnostické zobrazování metabolismus MeSH
- tropany MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
This is an international multicentre study aimed at evaluating the combined value of dopaminergic neuroimaging and clinical features in predicting future phenoconversion of idiopathic REM sleep behaviour (iRBD) subjects to overt synucleinopathy. Nine centres sent 123I-FP-CIT-SPECT data of 344 iRBD patients and 256 controls for centralized analysis. 123I-FP-CIT-SPECT images were semiquantified using DaTQUANTTM, obtaining putamen and caudate specific to non-displaceable binding ratios (SBRs). The following clinical variables were also analysed: (i) Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, motor section score; (ii) Mini-Mental State Examination score; (iii) constipation; and (iv) hyposmia. Kaplan-Meier survival analysis was performed to estimate conversion risk. Hazard ratios for each variable were calculated with Cox regression. A generalized logistic regression model was applied to identify the best combination of risk factors. Bayesian classifier was used to identify the baseline features predicting phenoconversion to parkinsonism or dementia. After quality check of the data, 263 iRBD patients (67.6 ± 7.3 years, 229 males) and 243 control subjects (67.2 ± 10.1 years, 110 males) were analysed. Fifty-two (20%) patients developed a synucleinopathy after average follow-up of 2 years. The best combination of risk factors was putamen dopaminergic dysfunction of the most affected hemisphere on imaging, defined as the lower value between either putamina (P < 0.000001), constipation, (P < 0.000001) and age over 70 years (P = 0.0002). Combined features obtained from the generalized logistic regression achieved a hazard ratio of 5.71 (95% confidence interval 2.85-11.43). Bayesian classifier suggested that patients with higher Mini-Mental State Examination score and lower caudate SBR asymmetry were more likely to develop parkinsonism, while patients with the opposite pattern were more likely to develop dementia. This study shows that iRBD patients older than 70 with constipation and reduced nigro-putaminal dopaminergic function are at high risk of short-term phenoconversion to an overt synucleinopathy, providing an effective stratification approach for future neuroprotective trials. Moreover, we provide cut-off values for the significant predictors of phenoconversion to be used in single subjects.
Centre of Sleep Medicine Dokkyo Medical University Hospital Tochigi Japan
Clinical Neurology Department of Neuroscience University of Genoa Italy
Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
Department of Brain and Behavioural Sciences University of Pavia Pavia Italy
Department of Neurology Dokkyo Medical University Saitama Medical Centre Saitama Japan
Department of Neurology Mayo Clinic Rochester Minnesota USA
Department of Nuclear Medicine Mayo Clinic Rochester Minnesota USA
Division of Sleep Medicine Kansai Electric Power Medical Research Institute Osaka Japan
Institute of Clinical Neurosciences University of Bristol Bristol UK
IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy
IRCCS Ospedale Policlinico San Martino Genoa Italy
National Institute of Nuclear Physics Genoa section Genoa Italy
Nuclear Medicine Department of Health Sciences University of Genoa Italy
Nuclear Medicine Unit ICS Maugeri SpA SB IRCCS Pavia Italy
Nuclear Medicine Unit University hospital of Montpellier France
PETIC University Hospital of Wales Cardiff UK
Radiation Physics and Protection Department Churchill Hospital Oxford UK
Sleep Disorder Centre Department of Medical Sciences and Public Health University of Cagliari Italy
Unit of Sleep Medicine and Epilepsy IRCCS Mondino Foundation Pavia Italy
Citace poskytuje Crossref.org
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