Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study

Iranzo, Álex; Lomeña, Francisco; Stockner, Heike; Valldeoriola, Francesc; Vilaseca, Isabel; Salamero, Manel; Molinuevo, José Luís; Serradell, Mónica; Duch, Joan; Pavı́a, Javier; Gallego, Judith; Seppi, Klaus; Högl, Birgit; Tolosa, Eduard; Poewe, Werner; Santamaría, Joan

doi:10.1016/s1474-4422(10)70216-7

Cited by 359 publications

(290 citation statements)

References 49 publications

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“…Several studies have shown that a substantial proportion of people with idiopathic RBD will subsequently develop dementia with cortical Lewy bodies [6]. A recent prospective study showed that 40% of patients with idiopathic RBD have nigral pathology and decreased striatal dopamine transporters as demonstrated by SPECT imaging and that such changes are associated with an increased risk of developing DLB [7]. …”

Section: Introductionmentioning

confidence: 99%

Early and Presenting Symptoms of Dementia with Lewy Bodies

Auning

Rongve

Fladby

et al. 2011

Dement Geriatr Cogn Disord

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Background/Aims: To explore the presenting and early symptoms of dementia with Lewy bodies (DLB). Method: Patients with mild dementia fulfilling diagnostic criteria for DLB (n = 61) and Alzheimer’s disease (AD) (n = 109) were recruited from outpatient dementia clinics in western Norway. At diagnosis, caregivers were asked which symptom had been the presenting symptom of dementia. Results: Caregivers reported that memory impairment was the most common presenting symptom in DLB (57%), followed by visual hallucinations (44%), depression (34%), problem solving difficulties (33%), gait problems (28%), and tremor/stiffness (25%). In contrast, 99% of AD carers reported impaired memory as a presenting symptom, whereas visual hallucinations were a presenting symptom in 3% of the AD cases. Conclusion: DLB should be suspected in predementia cases with visual hallucinations.

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Section: Introductionmentioning

confidence: 99%

Early and Presenting Symptoms of Dementia with Lewy Bodies

Auning

Rongve

Fladby

et al. 2011

Dement Geriatr Cogn Disord

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“…To maximize generalizability and eventual scalability, we focused on markers assessable in all patients. Many other variables could be assessed (and have been assessed in subcohorts) including MRI, 35 SPECT/PET, 36,37 transcranial ultrasound, 37 MIBG scintigraphy, 38 ECG, 39 EEG, 40 etc. Diagnosis of neurodegenerative disease remains clinical, and the time of "crossed threshold" is difficult to define; other clinicians may have diagnosed disease earlier or later than we did.…”

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confidence: 99%

Parkinson risk in idiopathic REM sleep behavior disorder

et al. 2015

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Objective: To precisely delineate clinical risk factors for conversion from idiopathic REM sleep behavior disorder (RBD) to Parkinson disease, dementia with Lewy bodies, and multiple system atrophy, in order to enable practical planning and stratification of neuroprotective trials against neurodegenerative synucleinopathy.Methods: In a 10-year prospective cohort, we tested prodromal Parkinson disease markers in 89 patients with idiopathic RBD. With Kaplan-Meier analysis, we calculated risk of neurodegenerative synucleinopathy, and using Cox proportional hazards, tested the ability of prodromal markers to identify patients at higher disease risk. By combining predictive markers, we then designed stratification strategies to optimally select patients for definitive neuroprotective trials.Results: The risk of defined neurodegenerative synucleinopathy was high: 30% developed disease at 3 years, rising to 66% at 7.5 years. Advanced age (hazard ratio [HR] 5 1.07), olfactory loss (HR 5 2.8), abnormal color vision (HR 5 3.1), subtle motor dysfunction (HR 5 3.9), and nonuse of antidepressants (HR 5 3.5) identified higher risk of disease conversion. However, mild cognitive impairment (HR 5 1. REM sleep behavior disorder (RBD) is characterized by loss of REM sleep paralysis, allowing patients to "act out" dreams.

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“…Loss of striatal dopamine transporter (DAT) binding on single photon emission computed tomography (DAT‐SPECT) indicates imminent phenoconversion 14, 15. In addition, RBD subjects with baseline hyposmia have a high risk of developing PD/DLB within 5 years of follow‐up 16, 17…”

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confidence: 99%

FDG PET, dopamine transporter SPECT, and olfaction: Combining biomarkers in REM sleep behavior disorder

et al. 2017

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BackgroundIdiopathic REM sleep behavior disorder is a prodromal stage of Parkinson's disease and dementia with Lewy bodies. Hyposmia, reduced dopamine transporter binding, and expression of the brain metabolic PD‐related pattern were each associated with increased risk of conversion to PD. The objective of this study was to study the relationship between the PD‐related pattern, dopamine transporter binding, and olfaction in idiopathic REM sleep behavior disorder.MethodsIn this cross‐sectional study, 21 idiopathic REM sleep behavior disorder subjects underwent 18F‐fluorodeoxyglucose PET, dopamine transporter imaging, and olfactory testing. For reference, we included 18F‐fluorodeoxyglucose PET data of 19 controls, 20 PD patients, and 22 patients with dementia with Lewy bodies. PD‐related pattern expression z‐scores were computed from all PET scans.ResultsPD‐related pattern expression was higher in idiopathic REM sleep behavior disorder subjects compared with controls (P = 0.048), but lower compared with PD (P = 0.001) and dementia with Lewy bodies (P < 0.0001). PD‐related pattern expression was higher in idiopathic REM sleep behavior disorder subjects with hyposmia and in subjects with an abnormal dopamine transporter scan (P < 0.05, uncorrected).ConclusionPD‐related pattern expression, dopamine transporter binding, and olfaction may provide complementary information for predicting phenoconversion. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study

Cited by 359 publications

References 49 publications

Early and Presenting Symptoms of Dementia with Lewy Bodies

Early and Presenting Symptoms of Dementia with Lewy Bodies

Parkinson risk in idiopathic REM sleep behavior disorder

FDG PET, dopamine transporter SPECT, and olfaction: Combining biomarkers in REM sleep behavior disorder

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