Isolated REM sleep behavior disorder (iRBD) is associated with impaired colour discrimination, cognitive deficits and morphological changes. This study evaluates whether colour discrimination deficits in iRBD are mediated by cognitive functions or related to dopaminergic denervation and brain morphology. A sample of 73 patients with iRBD and 77 controls underwent neuropsychological assessment, and colour discrimination assessment using the Farnsworth Munsell 100 Hue Test, DAT-SPECT, and MRI. The data were analyzed using multiple regression, mediation analysis, and voxel-based morphometry. Significant between-group differences were found in total colour discrimination as well as in the red-yellow spectrum. The association between iRBD and performance in the yellow-green spectrum was mediated by cognitive functions, as measured by the Montreal Cognitive Assessment. In controls, a positive correlation between the yellow-green spectrum and the left inferior frontal gyrus was observed compared to patients, however, this association was largely driven by a single data point. The performance in the green-blue spectrum was associated with the activity of dopamine transporters in the caudate nucleus. No interactions were found for total colour discrimination in any analysis. The present findings demonstrate a colour vision deficit in iRBD, which is not directly linked to any of the proposed potential explanatory mechanisms.

Department of Biomedical Informatics Faculty of Biomedical Engineering Czech Technical University Prague Prague Czech Republic

Department of Neurology and Centre of Clinical Neuroscience 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Zobrazit více v PubMed

American Academy of Sleep Medicine (2014) International classification of sleep disorders, 3rd edn. American Academy of Sleep Medicine, Darien IL, p 456

American Educational Research Association, American Psychological Association, National Council on Measurement in Education (2014) Standards for educational and psychological testing. American Educational Research Association, Washington DC, p 567

Arnaldi D, Mattioli P, Raffa S et al (2024) Presynaptic dopaminergic imaging characterizes patients with REM sleep behavior disorder due to synucleinopathy. Ann Neurol 95:1178–1192. https://doi.org/10.1002/ana.26902 PubMed DOI PMC

Beck AT, Steer RA, Brown GK (1996) Manual for the beck depression inventory-II. Psychological Corporation, San Antonio, TX

Bertrand JA, Bedetti C, Postuma RB et al (2012) Color discrimination deficits in parkinson’s disease are related to cognitive impairment and white-matter alterations. Mov Disord 27:1781–1788. https://doi.org/10.1002/mds.25272 PubMed DOI

Bezdicek O, Motak L, Axelrod BN et al (2012) Czech version of the trail making test: normative data and clinical utility. Arch Clin Neuropsych 27:906–914. https://doi.org/10.1093/arclin/acs084 DOI

Bezdicek O, Raskin SA, Altgassen M, Ruzicka E (2014a) Assessment of prospective memory—a validity study of memory for intentions screening test. Cesk Slov Neurol N 77:435–443

Bezdicek O, Stepankova H, Moták L et al (2014b) Czech version of rey auditory verbal learning test: normative data. Aging Neuropsychol Cogn 21:693–721. https://doi.org/10.1080/13825585.2013.865699 DOI

Bezdicek O, Lukavsky J, Stepankova H et al (2015) The prague stroop test: Normative standards in older czech adults and discriminative validity for mild cognitive impairment in parkinson’s disease. J Clin Exp Neuropsyc 37:794–807. https://doi.org/10.1080/13803395.2015.1057106 DOI

Buschke H (2014) Rationale of the memory binding test. Dementia and memory. Psychology Press, New York, NY, US, pp 55–71

Ciharova M, Cigler H, Dostalova V et al (2020) Beck depression inventory, czech version: demographic correlates, factor structure and comparison with foreign data. Int J Psychiatry Clin Pract 24:371–379. https://doi.org/10.1080/13651501.2020.1775854 PubMed DOI

Colzato LS, Sellaro R, Hulka LM et al (2014) Cognitive control predicted by color vision, and vice versa. Neuropsychologia 62:55–59. https://doi.org/10.1016/j.neuropsychologia.2014.07.010 PubMed DOI

Dall’Antonia I, Šonka K, Dušek P (2018) Olfaction and colour vision: What can they tell us about parkinson’s disease? Prague Med Rep 119:85–96. https://doi.org/10.14712/23362936.2018.8 PubMed DOI

Darcourt J, Booij J, Tatsch K et al (2010) EANM procedure guidelines for brain neurotransmission SPECT using (123)i-labelled dopamine transporter ligands, version 2. Eur J Nucl Med Mol Imaging 37:443–450. https://doi.org/10.1007/s00259-009-1267-x PubMed DOI

Diederich NJ, Sauvageot N, Pieri V et al (2020) The clinical non-motor connectome in early parkinson’s disease. J Parkinsons Dis 10:1797–1806. https://doi.org/10.3233/JPD-202102 PubMed DOI PMC

Dusek P, Ibarburu V, Bezdicek O et al (2019) Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder. Sci Rep 9:15463. https://doi.org/10.1038/s41598-019-51710-y PubMed DOI PMC

Farnsworth D (1957) The farnsworth-munsell 100-hue test: manual. Munsell Color Company, New York

Fereshtehnejad S-M, Yao C, Pelletier A et al (2019) Evolution of prodromal parkinson’s disease and dementia with lewy bodies: A prospective study. Brain 142:2051–2067. https://doi.org/10.1093/brain/awz111 PubMed DOI

Friederici AD (2011) The brain basis of language processing: From structure to function. Physiol Rev 91:1357–1392. https://doi.org/10.1152/physrev.00006.2011 PubMed DOI

Goetz CG, Tilley BC, Shaftman SR et al (2008) Movement disorder society-sponsored revision of the unified parkinson’s disease rating scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Mov Disord 23:2129–2170. https://doi.org/10.1002/mds.22340 PubMed DOI

Govindaiah G, Cox CL (2005) Excitatory actions of dopamine via D1-like receptors in the rat lateral geniculate nucleus. J Neurophysiol 94:3708–3718. https://doi.org/10.1152/jn.00583.2005 PubMed DOI

Grahn JA, Parkinson JA, Owen AM (2008) The cognitive functions of the caudate nucleus. Prog Neurobiol 86:141–155. https://doi.org/10.1016/j.pneurobio.2008.09.004 PubMed DOI

Haug BA, Kolle RU, Trenkwalder C et al (1995) Predominant affection of the blue cone pathway in parkinson’s disease. Brain 118(Pt 3):771–778. https://doi.org/10.1093/brain/118.3.771 PubMed DOI

Kim S, Choi JH, Woo KA et al (2024) Clinical correlates of pareidolias and color discrimination deficits in idiopathic REM sleep behavior disorder and parkinson’s disease. J Neural Transm 131:141–148. https://doi.org/10.1007/s00702-023-02724-4 PubMed DOI

Kløve H (1963) Clinical neuropsychology. In: Forster FM (ed) The medical clinics of north america. Saunders, New York, NY, pp 1647–1658

Kopecek M, Stepankova H, Lukavsky J et al (2016) Montreal cognitive assessment (MoCA): Normative data for old and very old czech adults. Appl Neuropsychol Adult 24:23–29. https://doi.org/10.1080/23279095.2015.1065261 PubMed DOI

Kordower JH, Olanow CW, Dodiya HB et al (2013) Disease duration and the integrity of the nigrostriatal system in parkinson’s disease. Brain 136:2419–2431. https://doi.org/10.1093/brain/awt192 PubMed DOI PMC

Li Y, Zhang H, Mao W et al (2019) Visual dysfunction in patients with idiopathic rapid eye movement sleep behavior disorder. Neurosci Lett 709:134360. https://doi.org/10.1016/j.neulet.2019.134360 PubMed DOI

Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in parkinson’s disease: movement disorder society task force guidelines. Mov Disord 27:349–356. https://doi.org/10.1002/mds.24893 PubMed DOI PMC

Marques A, Dujardin K, Boucart M et al (2010) REM sleep behaviour disorder and visuoperceptive dysfunction: a disorder of the ventral visual stream? J Neurol 257:383–391. https://doi.org/10.1007/s00415-009-5328-7 PubMed DOI

Matar E, Phillips JR, Martens KAE et al (2019) Impaired color discrimination—a specific marker of hallucinations in lewy body disorders. J Geriatr Psych Neur 32:257–264. https://doi.org/10.1177/0891988719845501 DOI

Muller T, Kuhn W, Buttner T et al (1998) Colour vision abnormalities do not correlate with dopaminergic nigrostriatal degeneration in parkinson’s disease. J Neurol 245:659–664. https://doi.org/10.1007/s004150050263 PubMed DOI

Nasreddine ZS, Phillips NA, Bedirian V et al (2005) The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x PubMed DOI

Nikolai T, Štěpánková H, Michalec J et al (2015) Testy verbální fluence, česká normativní studie pro osoby vyššího věku. Cesk Slov Neurol N 78(111):292–299. https://doi.org/10.14735/amcsnn2015292 DOI

Ortuno-Lizaran I, Sanchez-Saez X, Lax P et al (2020) Dopaminergic retinal cell loss and visual dysfunction in parkinson disease. Ann Neurol 88:893–906. https://doi.org/10.1002/ana.25897 PubMed DOI PMC

Polo V, Satue M, Rodrigo MJ et al (2016) Visual dysfunction and its correlation with retinal changes in patients with parkinson’s disease: an observational cross-sectional study. BMJ Open 6:e009658. https://doi.org/10.1136/bmjopen-2015-009658 PubMed DOI PMC

Postuma RB, Lang AE, Massicotte-Marquez J, Montplaisir J (2006) Potential early markers of parkinson disease in idiopathic REM sleep behavior disorder. Neurology 66:845–851. https://doi.org/10.1212/01.wnl.0000203648.80727.5b PubMed DOI

Postuma RB, Gagnon JF, Vendette M, Montplaisir JY (2009) Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and parkinson’s disease. Brain 132:3298–3307. https://doi.org/10.1093/brain/awp244 PubMed DOI

Postuma RB, Gagnon JF, Bertrand JA et al (2015) Parkinson risk in idiopathic REM sleep behavior disorder: preparing for neuroprotective trials. Neurology 84:1104–1113. https://doi.org/10.1212/WNL.0000000000001364 PubMed DOI PMC

Purves D, Augustine GJ, Fitzpatrick D et al (2018) Neuroscience, 6th edn. Oxford University Press, Sunderland, MA

Rahayel S, Postuma RB, Montplaisir J et al (2018) Cortical and subcortical gray matter bases of cognitive deficits in REM sleep behavior disorder. Neurology 90:e1759–e1770. https://doi.org/10.1212/WNL.0000000000005523 PubMed DOI PMC

Raskin S, Buckheit C, Sherrod C (2010) Memory for intentions test Professional manual. Psychological Assessment Resources, Lutz

Roux FE, Lubrano V, Lauwers-Cances V et al (2006) Category-specific cortical mapping: Color-naming areas. J Neurosurg 104:27–37. https://doi.org/10.3171/jns.2006.104.1.27 PubMed DOI

Sartucci F, Orlandi G, Lucetti C et al (2003) Changes in pattern electroretinograms to equiluminant red-green and blue-yellow gratings in patients with early parkinson’s disease. J Clin Neurophysiol 20:375–381. https://doi.org/10.1097/00004691-200309000-00010 PubMed DOI

Siuda-Krzywicka K, Witzel C, Bartolomeo P, Cohen L (2021) Color naming and categorization depend on distinct functional brain networks. Cereb Cortex 31:1106–1115. https://doi.org/10.1093/cercor/bhaa278 PubMed DOI

Smith A (1982) Symbol digits modalities test: Manual. Western Psychological Services, Los Angeles, CA

Spielberger CD, Gorsuch RL, Lushene RD et al (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto, CA

Therneau TM (2024) A package for survival analysis in R. Version 3.6-4. [computer program]. https://cran.r-project.org/package=survival

Tingley D, Yamamoto T, Hirose K et al (2014) mediation: R package for causal mediation analysis. J Stat Softw 59:1–38. https://doi.org/10.18637/jss.v059.i05 DOI

Unger MM, Belke M, Menzler K et al (2010) Diffusion tensor imaging in idiopathic REM sleep behavior disorder reveals microstructural changes in the brainstem, substantia nigra, olfactory region, and other brain regions. Sleep 33:767–773. https://doi.org/10.1093/sleep/33.6.767 PubMed DOI PMC

Wechsler D (2010) Wechslerova inteligenční škála pro dospělé. Hogrefe - Testcentrum, Praha

Youn S, Kim T, Yoon IY et al (2016) Progression of cognitive impairments in idiopathic REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry 87:890–896. https://doi.org/10.1136/jnnp-2015-311437 PubMed DOI

Zarkali A, McColgan P, Leyland L et al (2021) Visual dysfunction predicts cognitive impairment and white matter degeneration in parkinson’s disease. Movement Disord 36:1191–1202. https://doi.org/10.1002/mds.28477 PubMed DOI