BACKGROUND: Speech dysfunction represents one of the initial motor manifestations to develop in Parkinson's disease (PD) and is measurable through smartphone. OBJECTIVE: The aim was to develop a fully automated and noise-resistant smartphone-based system that can unobtrusively screen for prodromal parkinsonian speech disorder in subjects with isolated rapid eye movement sleep behavior disorder (iRBD) in a real-world scenario. METHODS: This cross-sectional study assessed regular, everyday voice call data from individuals with iRBD compared to early PD patients and healthy controls via a developed smartphone application. The participants also performed an active, regular reading of a short passage on their smartphone. Smartphone data were continuously collected for up to 3 months after the standard in-person assessments at the clinic. RESULTS: A total of 3525 calls that led to 5990 minutes of preprocessed speech were extracted from 72 participants, comprising 21 iRBD patients, 26 PD patients, and 25 controls. With a high area under the curve of 0.85 between iRBD patients and controls, the combination of passive and active smartphone data provided a comparable or even more sensitive evaluation than laboratory examination using a high-quality microphone. The most sensitive features to induce prodromal neurodegeneration in iRBD included imprecise vowel articulation during phone calls (P = 0.03) and monopitch in reading (P = 0.05). Eighteen minutes of speech corresponding to approximately nine calls was sufficient to obtain the best sensitivity for the screening. CONCLUSION: We consider the developed tool widely applicable to deep longitudinal digital phenotyping data with future applications in neuroprotective trials, deep brain stimulation optimization, neuropsychiatry, speech therapy, population screening, and beyond. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

• MeSH
• biologické markery MeSH
• chytrý telefon * MeSH
• hlas fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc * patofyziologie   komplikace   MeSH
• parkinsonské poruchy patofyziologie   MeSH
• porucha chování v REM spánku * patofyziologie   diagnóza   MeSH
• poruchy řeči etiologie   MeSH
• prodromální symptomy MeSH
• průřezové studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• neurodegenerativní nemoci diagnóza   klasifikace   komplikace   MeSH
• obstrukční spánková apnoe diagnóza   etiologie   komplikace   MeSH
• parasomnie spojené s REM spánkem * diagnóza   klasifikace   patofyziologie   terapie   MeSH
• parasomnie klasifikace   MeSH
• porucha chování v REM spánku diagnóza   klasifikace   patofyziologie   terapie   MeSH
• posttraumatická stresová porucha etiologie   komplikace   MeSH
• senioři MeSH
• sny psychologie   MeSH
• syndrom neklidných nohou diagnóza   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Parasomnie sú poruchy spánku, z nich niektoré majú väzbu na určité spánkové štádium. NREM (non­‐rapid eye movement) parasomnie - tiež nazývané ako poruchy prebúdzania z NREM spánku - sú somnambulizmus, pavor nocturnus, prebúdzanie so zmätenosťou. Poväčšine majú benigný charakter, najvačším nebezpečenstvom je možnosť vzniku tramatu následkom epizódy parasomnie. Najčastejšie vznikajú v detstve a so vzrastajúcim vekom zanikajú. Ak vzniknú v dospelosti, môže to byť na podklade psychopatológie, asociované sú s úzkostne­‐depresívnou symptomatikou alebo abúsom návykových látok či alkoholu. K REM (rapid eye movement) parasomniám patria nočné mory, rekurentná izolovaná spánková paralýza a porucha chovania v REM spánku Občasné nočné mory sa vyskytujú vo väčšine detskej populácie, pri vysokej frekvencii epizód s ťažko dysforickými snami, môžeme hovoriť o poruche s nočnými morami. V dospelosti je táto porucha asociovaná s komorbidnou psychopatológiou, najmä postrtaumatickou stresovou poruchou. Porucha chovania v REM spánku má vysokú koreláciu so synukleinopatiami, môže sa objaviť ako prvý príznak neurodegeneratívneho ochorenia, niekedy až roky pred prvými typickými symptómami daného ochorenia.

Parasomnias are sleep disorders, some of which are connected to specific sleep phases. Among NREM (non-rapid eye movement) parasomnias belong somnambulism or sleep walking, pavor nocturnus or sleep terrors, confusional arousal. Most of the time they are bening, the biggest danger is occurrence of injuries as a consequence of episode of parasomnia. The onset is most common in childhood and they disappear with age. The onset is in adulthood can be due to psychopathology, based on research there is association with anxiety and depressive disorders or with alcoholism or substance abuse. Among REM (rapid eye movement) parasomnias belong nightmare disorder, recurrent isolated sleep paralysis and REM sleep behavior disorder (RBD). Occasional nightmares occur in most of children, if the frequency of the episodes is too high and the dreams are quite distressing, we can talk about nightmare disorder. In adulthood it ́s associated with comorbid psychopathology, most commonly post-traumatic stress disorder. REM sleep behavior disorder has high correlation with synucleinopathies. It can be one of the first symptoms of neurodegenerative disease, sometimes years before disease-specific symptoms appear.

• MeSH
• lidé MeSH
• parasomnie * klasifikace   patofyziologie   MeSH
• porucha chování v REM spánku diagnóza   patofyziologie   MeSH
• poruchy příjmu potravy diagnóza   terapie   MeSH
• poruchy probouzení ze spánku diagnóza   patofyziologie   terapie   MeSH
• somnambulismus patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

OBJECTIVE: This multilanguage study used simple speech recording and high-end pattern analysis to provide sensitive and reliable noninvasive biomarkers of prodromal versus manifest α-synucleinopathy in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) and early-stage Parkinson disease (PD). METHODS: We performed a multicenter study across the Czech, English, German, French, and Italian languages at 7 centers in Europe and North America. A total of 448 participants (337 males), including 150 with iRBD (mean duration of iRBD across language groups 0.5-3.4 years), 149 with PD (mean duration of disease across language groups 1.7-2.5 years), and 149 healthy controls were recorded; 350 of the participants completed the 12-month follow-up. We developed a fully automated acoustic quantitative assessment approach for the 7 distinctive patterns of hypokinetic dysarthria. RESULTS: No differences in language that impacted clinical parkinsonian phenotypes were found. Compared with the controls, we found significant abnormalities of an overall acoustic speech severity measure via composite dysarthria index for both iRBD (p = 0.002) and PD (p < 0.001). However, only PD (p < 0.001) was perceptually distinct in a blinded subjective analysis. We found significant group differences between PD and controls for monopitch (p < 0.001), prolonged pauses (p < 0.001), and imprecise consonants (p = 0.03); only monopitch was able to differentiate iRBD patients from controls (p = 0.004). At the 12-month follow-up, a slight progression of overall acoustic speech impairment was noted for the iRBD (p = 0.04) and PD (p = 0.03) groups. INTERPRETATION: Automated speech analysis might provide a useful additional biomarker of parkinsonism for the assessment of disease progression and therapeutic interventions. ANN NEUROL 2021;90:62-75.

• MeSH
• biologické markery MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc diagnóza   patofyziologie   MeSH
• porucha chování v REM spánku diagnóza   patofyziologie   MeSH
• prodromální symptomy MeSH
• progrese nemoci MeSH
• řeč fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVES: Hyperechogenicity of the substantia nigra (SN) and abnormal dopamine transporter-single-photon emission computed tomography (DAT-SPECT) are biomarkers commonly used in the assessment of prodromal synucleinopathy. Our goals were as follows: (1) to compare echogenicity of SN in idiopathic rapid eye movement (REM) behavior disorder (iRBD), Parkinson's disease (PD) without RBD (PD-noRBD), PD with RBD (PD + RBD), and control subjects; and (2) to examine association between SN degeneration assessed by DAT-SPECT and SN echogenicity. PATIENTS/METHODS: A total of 61 subjects with confirmed iRBD were examined using Movement Disorders Society-unified PD rating scale (MDS-UPDRS), TCS (transcranial sonography) and DAT-SPECT. The results were compared with 44 patients with PD (25% PD + RBD) and with 120 age-matched healthy subjects. RESULTS AND CONCLUSION: The abnormal SN area was found in 75.5% PD, 23% iRBD and 7.3% controls. Median SN echogenicity area in PD (0.27 ± 0.22 cm2) was higher compared to iRBD (0.07 ± 0.07 cm2; p < 0.0001) and controls (0.05 ± 0.03 cm2; p < 0.0001). SN echogenicity in PD + RBD was not significantly different from PD-noRBD (0.30 vs. 0.22, p = 0.15). Abnormal DAT-SPECT was found in 16 iRBD (25.4%) and 44 PD subjects (100%). No correlation between the larger SN area and corresponding putaminal binding index was found in iRBD (r = -0.13, p = 0.29), nor in PD (r = -0.19, p = 0.22). The results of our study showed that: (1) SN echogenicity area in iRBD was higher compared to controls, but the hyperechogenicity was present only in a minority of iRBD patients; (2) SN echogenicity and DAT-SPECT binding index did not correlate in either group; and (3) SN echogenicity does not differ between PD with/without RBD.

• MeSH
• jednofotonová emisní výpočetní tomografie MeSH
• lidé MeSH
• nortropany MeSH
• porucha chování v REM spánku * diagnostické zobrazování   patofyziologie   MeSH
• radioizotopy jodu MeSH
• substantia nigra * diagnostické zobrazování   patofyziologie   MeSH
• synukleinopatie * diagnostické zobrazování   patofyziologie   MeSH
• ultrasonografie dopplerovská transkraniální MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The aim of this study was to evaluate associations of motor and non-motor symptoms with dopamine transporter binding in prodromal stage of synucleinopathies. We examined 74 patients with idiopathic REM sleep behavior disorder (RBD), which is a prodromal synucleinopathy, and 39 controls using Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment, University of Pennsylvania Smell Identification Test (UPSIT), Farnsworth-Munsell 100 hue test, orthostatic test, Scales for Outcomes in PD-Autonomic, Beck depression inventory-II, State-Trait Anxiety Inventory, and video-polysomnography. Electromyographic muscle activity during REM sleep was quantified according to Sleep Innsbruck-Barcelona criteria. In 65 patients, dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging was performed, putaminal binding ratio was calculated and scans were classified as normal, borderline, or abnormal. Compared to controls, RBD patients had significantly more severe scores in all examined tests. Patients with abnormal DAT-SPECT had higher MDS-UPDRS motor score (p = 0.006) and higher prevalence of orthostatic hypotension (p = 0.008). Putaminal binding ratio was positively associated with UPSIT score (p = 0.03) and negatively associated with tonic (p = 0.003) and phasic (p = 0.01) muscle activity during REM sleep. These associations likely reflect simultaneous advancement of underlying pathology in substantia nigra and susceptible brainstem and olfactory nuclei in prodromal synucleinopathy.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• polysomnografie MeSH
• porucha chování v REM spánku metabolismus   patofyziologie   MeSH
• proteiny přenášející dopamin přes plazmatickou membránu metabolismus   MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• testy pro posouzení mentálních funkcí a demence MeSH
• vazba proteinů MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

STUDY OBJECTIVES: Rapid eye movement (REM) sleep without atonia (RWA) is the main polysomnographic feature of idiopathic REM sleep behavior disorder (iRBD) and is considered to be a promising biomarker predicting conversion to manifested synucleinopathy. Besides conventionally evaluated tonic, phasic and any RWA, we took into consideration also periods, when phasic and tonic RWA appeared simultaneously and we called this activity "mixed RWA." The study aimed to evaluate different types of RWA, to reveal the most relevant biomarker to the conversion. METHODS: A total of 55 patients with confirmed iRBD were recruited with mean follow-up duration 2.3 ± 0.7 years. Scoring of RWA was based on Sleep Innsbruck Barcelona rules. Positive phenocoversion was ascertained according to standard diagnostic criteria during follow-up. Receiver operator characteristic analysis was applied to evaluate predictive performance of different RWA types. RESULTS: A total of nine patients (16%) developed neurodegenerative diseases. Yearly phenoconversion rate was 5.5%. Significantly higher amounts of mixed (p = 0.009), tonic (p = 0.020), and any RWA (p = 0.049) were found in converters. Optimal cutoffs differentiating the prediction were 16.4% (sensitivity 88.9; specificity 69.6) for tonic, 4.4% (sensitivity 88.9; specificity 60.9) for mixed, and 36.8% (sensitivity 77.8; specificity 65.2) for any RWA. With area under the curve (AUC) 0.778, mixed RWA has proven to be the best predictive test followed by tonic (AUC 0.749) and any (AUC 0.710). CONCLUSIONS: Mixed, tonic and any RWA may serve as biomarkers predicting the conversion into neurodegenerative disease in iRBD. The best predictive value lies within mixed RWA, thus it should be considered as standard biomarker.

• MeSH
• alfa-synuklein metabolismus   MeSH
• biologické markery MeSH
• kofein MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurodegenerativní nemoci patologie   MeSH
• polysomnografie MeSH
• porucha chování v REM spánku patofyziologie   MeSH
• ROC křivka MeSH
• sběr dat MeSH
• senioři MeSH
• spánek REM fyziologie   MeSH
• svalová hypotonie patofyziologie   MeSH
• synukleinopatie patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

Abnormalities of eye movements have been reported in patients with Parkinson's disease (PD). However, it is unclear if they occur in the prodromal stage of synucleinopathy represented by idiopathic rapid eye movement sleep behaviour disorder (iRBD). We thus aimed to study eye movements in subjects with iRBD and in de novo PD, to assess if their abnormalities may serve as a clinical biomarker of neurodegeneration. Fifty subjects with polysomnography-confirmed iRBD (46 male, age 40-79 years), 18 newly diagnosed, untreated PD patients (13 male, age 43-75 years) and 25 healthy controls (20 male, age 42-79 years) were prospectively enrolled. Horizontal and vertical ocular prosaccades and antisaccades were investigated with video-oculography. All patients completed the MDS-UPDRS and the Montreal Cognitive Assessment. In addition, a neuropsychological battery was performed on iRBD subjects. When compared with healthy controls, both de novo PD patients and iRBD subjects showed increased error rates in the horizontal antisaccade task (p < 0.01, p < 0.05 respectively). In the iRBD group, the error rates in horizontal and vertical antisaccades correlated with performances in the Prague Stroop Test and the Grooved Pegboard Test, as well as with motor scores of the MDS-UPDRS. De novo PD patients showed a lower gain (p < 0.01) compared with controls. In conclusion, the increased error rate in the antisaccade task of iRBD and PD patients reflects a dysfunction of the dorsolateral prefrontal cortex and is related to the impairment of executive functions and attention.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc patofyziologie   MeSH
• pohyby očí fyziologie   MeSH
• polysomnografie metody   MeSH
• porucha chování v REM spánku komplikace   patofyziologie   MeSH
• prefrontální mozková kůra abnormality   MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• antidepresiva škodlivé účinky   MeSH
• lidé MeSH
• multisystémová atrofie komplikace   patofyziologie   MeSH
• narkolepsie komplikace   patofyziologie   MeSH
• parasomnie spojené s REM spánkem patofyziologie   MeSH
• parasomnie patofyziologie   MeSH
• parkinsonské poruchy komplikace   patofyziologie   MeSH
• porucha chování v REM spánku * diagnóza   patofyziologie   terapie   MeSH
• spánek REM fyziologie   účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Idiopathic REM sleep behaviour disorder (iRBD) is a powerful early sign of Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. This provides an unprecedented opportunity to directly observe prodromal neurodegenerative states, and potentially intervene with neuroprotective therapy. For future neuroprotective trials, it is essential to accurately estimate phenoconversion rate and identify potential predictors of phenoconversion. This study assessed the neurodegenerative disease risk and predictors of neurodegeneration in a large multicentre cohort of iRBD. We combined prospective follow-up data from 24 centres of the International RBD Study Group. At baseline, patients with polysomnographically-confirmed iRBD without parkinsonism or dementia underwent sleep, motor, cognitive, autonomic and special sensory testing. Patients were then prospectively followed, during which risk of dementia and parkinsonsim were assessed. The risk of dementia and parkinsonism was estimated with Kaplan-Meier analysis. Predictors of phenoconversion were assessed with Cox proportional hazards analysis, adjusting for age, sex, and centre. Sample size estimates for disease-modifying trials were calculated using a time-to-event analysis. Overall, 1280 patients were recruited. The average age was 66.3 ± 8.4 and 82.5% were male. Average follow-up was 4.6 years (range = 1-19 years). The overall conversion rate from iRBD to an overt neurodegenerative syndrome was 6.3% per year, with 73.5% converting after 12-year follow-up. The rate of phenoconversion was significantly increased with abnormal quantitative motor testing [hazard ratio (HR) = 3.16], objective motor examination (HR = 3.03), olfactory deficit (HR = 2.62), mild cognitive impairment (HR = 1.91-2.37), erectile dysfunction (HR = 2.13), motor symptoms (HR = 2.11), an abnormal DAT scan (HR = 1.98), colour vision abnormalities (HR = 1.69), constipation (HR = 1.67), REM atonia loss (HR = 1.54), and age (HR = 1.54). There was no significant predictive value of sex, daytime somnolence, insomnia, restless legs syndrome, sleep apnoea, urinary dysfunction, orthostatic symptoms, depression, anxiety, or hyperechogenicity on substantia nigra ultrasound. Among predictive markers, only cognitive variables were different at baseline between those converting to primary dementia versus parkinsonism. Sample size estimates for definitive neuroprotective trials ranged from 142 to 366 patients per arm. This large multicentre study documents the high phenoconversion rate from iRBD to an overt neurodegenerative syndrome. Our findings provide estimates of the relative predictive value of prodromal markers, which can be used to stratify patients for neuroprotective trials.

• MeSH
• demence s Lewyho tělísky patofyziologie   MeSH
• demence patofyziologie   MeSH
• Kaplanův-Meierův odhad MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc patofyziologie   MeSH
• parkinsonské poruchy diagnóza   MeSH
• polysomnografie MeSH
• porucha chování v REM spánku patofyziologie   MeSH
• předpověď metody   MeSH
• prodromální symptomy MeSH
• prognóza MeSH
• progrese nemoci MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH