글로벌 연구동향
핵의학
- 2022년 08월호
[Neurology.] Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder서울의대 / 윤은진, 김유경*
- 출처
- Neurology.
- 등재일
- 2022 Jun 14
- 저널이슈번호
- 98(24):e2413-e2424. doi: 10.1212/WNL.0000000000200326.
- 내용
Abstract
Background and objectives: Mild cognitive impairment (MCI) in isolated REM sleep behavior disorder (iRBD) is a risk factor for subsequent neurodegeneration. We aimed to identify brain metabolism and functional connectivity changes related to MCI in patients with iRBD and the neuroimaging markers' predictive value for phenoconversion.Methods: This is a prospective cohort study of patients with iRBD with a mean follow-up of 4.2 ± 2.6 years. At baseline, patients with iRBD and age- and sex-matched healthy controls (HCs) underwent 18F-fluorodeoxyglucose (FDG)-PET and resting-state fMRI scans and a comprehensive neuropsychological test battery. Voxel-wise group comparisons for FDG-PET data were performed using a general linear model. Seed-based connectivity maps were computed using brain regions showing significant hypometabolism associated with MCI in patients with iRBD and compared between groups. A Cox regression analysis was applied to investigate the association between brain metabolism and risk of phenoconversion.
Results: Forty patients with iRBD, including 21 with MCI (iRBD-MCI) and 19 with normal cognition (iRBD-NC), and 24 HCs were included in the study. The iRBD-MCI group revealed relative hypometabolism in the inferior parietal lobule, lateral and medial occipital, and middle and inferior temporal cortex bilaterally compared with HC and the iRBD-NC group. In seed-based connectivity analyses, the iRBD-MCI group exhibited decreased functional connectivity of the left angular gyrus with the occipital cortex. Of 40 patients with iRBD, 12 patients converted to Parkinson disease (PD) or dementia with Lewy bodies (DLB). Hypometabolism of the occipital pole (hazard ratio [95% CI] 6.652 [1.387-31.987]), medial occipital (4.450 [1.143-17.327]), and precuneus (3.635 [1.009-13.093]) was associated with higher phenoconversion rate to PD/DLB.
Discussion: MCI in iRBD is related to functional and metabolic changes in broad brain areas, particularly the occipital and parietal areas. Moreover, hypometabolism in these brain regions was a predictor of phenoconversion to PD or DLB. Evaluation of cognitive function and neuroimaging characteristics could be useful for risk stratification in patients with iRBD.
Affiliations
Eun Jin Yoon 1 , Jee-Young Lee 1 , Heejung Kim 2 , Dallah Yoo 1 , Jung Hwan Shin 1 , Hyunwoo Nam 1 , Beomseok Jeon 1 , Yu Kyeong Kim 2
1 From the Memory Network (E.J.Y.) and Institute of Radiation Medicine (H.K.), Medical Research Center, Seoul National University; Departments of Nuclear Medicine (E.J.Y., H.K., Y.K.K.) and Neurology (J.-Y.L., D.Y., J.H.S., H.N.), Seoul National University-Seoul Metropolitan Government Boramae Medical Center, and Department of Neurology (B.J.), Seoul National University College of Medicine; and Department of Neurology (D.Y.), Kyung Hee University Hospital, Seoul, Korea.
2 From the Memory Network (E.J.Y.) and Institute of Radiation Medicine (H.K.), Medical Research Center, Seoul National University; Departments of Nuclear Medicine (E.J.Y., H.K., Y.K.K.) and Neurology (J.-Y.L., D.Y., J.H.S., H.N.), Seoul National University-Seoul Metropolitan Government Boramae Medical Center, and Department of Neurology (B.J.), Seoul National University College of Medicine; and Department of Neurology (D.Y.), Kyung Hee University Hospital, Seoul, Korea. yk3181@snu.ac.kr.
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편집위원
Isolated REM Sleep Behavior Disorder 환자에서 MCI 동반은 향후 퇴행성 뇌질환의 위험인자이다. FDG PET으로 평가가 되는 기능대사 변화 (특히, 후두 및 측두엽의)가 향후 파킨슨 병 혹은 루이소체 치매 발생을 예측할 수 있음을 보여준 임상 연구임. 퇴행성 뇌질환 진료 신경학 의사 및 핵의학 임상가에게 관심을 끌 연구로 생각됨.
덧글달기닫기2022-08-02 14:33:27
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