Reduced cardiac
            <sup>123</sup>
            I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

Miyamoto, Tomoyuki; Miyamoto, Masayuki; Inoue, Yuichi; Usui, Yasuhiro; Suzuki, Keisuke; Hirata, Koichi

doi:10.1212/01.wnl.0000249313.25627.2e

Cited by 232 publications

(161 citation statements)

References 7 publications

(14 reference statements)

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“…[1][2][3] Synucleinopathies were often associated with symptoms of autonomic dysfunction, such as impaired blood pressure control and reduced heart rate variability. 4,5 Consistently, individuals with idiopathic RBD experienced worse autonomic function, including cardiovascular, gastrointestinal, and urinary domains, relative to control participants. 6,7 The autonomic nervous system may have a role in the prepathologic state or contribute to the precipitating factors of the acute phase of stroke, such as atherosclerosis and sympathetic hyperactivity.…”

mentioning

confidence: 84%

Probable REM sleep behavior disorder and risk of stroke

Pavlova

Liu

et al. 2017

Neurology

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Objective: To examine whether probable REM sleep behavior disorder (pRBD) was associated with increased risk of developing stroke in a community-based cohort. Methods:The study included 12,003 participants (mean age 54.0 years) of the Kailuan Study, free of stroke, cancer, Parkinson disease, dementia, and head injury at baseline (2012). We determined pRBD using a validated REM sleep behavior disorder (RBD) questionnaire in 2012. Incident stroke cases were confirmed by review of medical records. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke according to pRBD status, adjusting for several sleep measures (i.e., insomnia, daytime sleepiness, sleep duration, snoring, and use of hypnotics) and other potential confounders.Results: During 3 years of follow-up, we documented 159 incident stroke cases. Relative to participants without pRBD at the baseline, those with pRBD had a 157% higher risk (95% CI 59%-313%) of developing stroke. Presence of pRBD was associated with increased risk of both stroke types-the adjusted HR was 1.93 (95% CI 1.07-3.46) for ischemic stroke and 6.61 (95% CI 2.27-19.27) for hemorrhagic stroke.Conclusions: Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association. Neurology ® 2017;88:1849-1855 GLOSSARY AIS 5 Athens Insomnia Scale; BMI 5 body mass index; CI 5 confidence interval; ESS 5 Epworth Sleepiness Scale; HDL-C 5 high-density lipoprotein cholesterol; HR 5 hazard ratio; ICD-10 5 International Classification of Diseases-10; LDL-C 5 lowdensity lipoprotein cholesterol; OR 5 odds ratio; OSA 5 obstructive sleep apnea; PD 5 Parkinson disease; pRBD 5 probable REM sleep behavior disorder; RBD 5 REM sleep behavior disorder; RBDQ-HK 5 RBD questionnaire-Hong Kong; RMB 5 renminbi.REM sleep behavior disorder (RBD) is associated with synucleinopathies, and a large proportion of individuals with RBD may already have or later develop Parkinson disease (PD), dementia with Lewy bodies, or multiple system atrophy. [1][2][3] Synucleinopathies were often associated with symptoms of autonomic dysfunction, such as impaired blood pressure control and reduced heart rate variability. 4,5 Consistently, individuals with idiopathic RBD experienced worse autonomic function, including cardiovascular, gastrointestinal, and urinary domains, relative to control participants. 6,7 The autonomic nervous system may have a role in the prepathologic state or contribute to the precipitating factors of the acute phase of stroke, such as atherosclerosis and sympathetic hyperactivity. 8 Some case reports suggested that stroke may cause RBD. 9-11 In a previous cross-sectional study, we also found that individuals with probable RBD (pRBD) had higher odds of several concurrent stroke risk factors, such as diabetes and hyperlipidemia. 12 However, whether RBD predicts subsequ...

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confidence: 84%

Probable REM sleep behavior disorder and risk of stroke

Pavlova

Liu

et al. 2017

Neurology

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“…The 123I-MIBG studies showed markedly decreased cardiac uptake in PD, DLB and PAF, which is a common feature of Lewy body diseases (Courbon et al, 2003;Kashihara et al, 2006;Yoshita et al, 2006). We reported markedly reduced cardiac 123I-MIBG uptake in iRBD as well as in PD or DLB (Miyamoto et al, 2006;Miyamoto et al, 2008) (Figure 5). In our recent case report ), we described a small subset of iRBD patients who have relatively preserved uptake at RBD onset, but which then becomes lost over the follow-up period.…”

Section: I-mibg Scintigraphymentioning

confidence: 50%

“…Idiopathic RBD (iRBD), which develops in middle age or later and progresses chronically, in particular is a common clinical manifestation of Lewy body-related syndrome and is regarded as a clinical entity from pathological aspects. For example (Table 1), it has been elucidated that iRBD is often accompanied by soft motor signs, olfactory and color identification deficits, decreased cardiovascular and respiratory changes between REM and Non-REM sleep, reduced cardiac 123 I-metaiodobenzylguanidine (123I-MIBG) uptake, impairment of visual memory and visuo-spatial construction revealed by neuropsychological testing, EEG slowing during wakefulness or sleep, and decreased strial dopaminergic innervation and reduced pre-synaptic strial dopamine transporter binding on SPECT or positron emission topography (PET) scans, which are considered as non-motor symptoms of Parkinson's disease (PD) (Becker et al, 2002;Gagnon et al, 2006;Miyamoto et al, 2006;Miyamoto et al, 2008). Furthermore, despite the limited number of pathological reports on iRBD, the characteristics of iRBD have been supported to have a close relationship with Lewy body pathology .…”

Section: Introductionmentioning

confidence: 99%

Combinations of Markers Provide Clues to the Underlying Neurodegenerative Disorder in REM Sleep Behavior Disorder

Miyamoto¹,

Miyamoto²

2011

Diagnosis and Treatment of Parkinson's Disease

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“…REM behavior disorder (RBD) is a new pathological entity associated with PD. RBD patients present an evident myocardial noradrenergic denervation as demonstrated by cardiac sympathetic neuroimaging [21,22]. Most PD patients may eventually develop dementia.…”

Section: Sympathetic System In Parkinson's Diseasementioning

confidence: 99%

Neurological applications for myocardial MIBG scintigraphy

Cacace²,

Antonio³

et al. 2013

Nucl. Med. Rev.

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Signs or symptoms of impaired autonomic regulation of circulation are typically present in patients affected by Parkinson's disease (PD), in agreement with the cardiac sympathetic denervation discovered by Goldstein more than 15 yrs. ago.In particular, the majority of PD patients have a diffuse left ventricular myocardial sympathetic denervation, being a normal neurological condition present only in a small number of affected subjects. Actually MIBG cardiac imaging is a universally accepted method to estimate cardiac sympathetic innervations. This review covers the role of MIBG cardiac imaging in PD as well as in other parkinsonisms, focusing the attention on technical problems and pathophysiological premises for cardiac denervation. In particular new emerging data support the role of MIBG as biomarker of PD, also before motor symptoms became clinically evident. Therefore the timing of cardiac noradrenergic denervation in PD is a key issue and we want to update the analysis of autonomic cardiovascular abnormalities studied with MIBG in PD and related disorders.

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Reduced cardiac ¹²³ I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

Cited by 232 publications

References 7 publications

Probable REM sleep behavior disorder and risk of stroke

Probable REM sleep behavior disorder and risk of stroke

Combinations of Markers Provide Clues to the Underlying Neurodegenerative Disorder in REM Sleep Behavior Disorder

Neurological applications for myocardial MIBG scintigraphy

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Reduced cardiac 123 I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

Cited by 232 publications

References 7 publications

Probable REM sleep behavior disorder and risk of stroke

Probable REM sleep behavior disorder and risk of stroke

Combinations of Markers Provide Clues to the Underlying Neurodegenerative Disorder in REM Sleep Behavior Disorder

Neurological applications for myocardial MIBG scintigraphy

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Reduced cardiac ¹²³ I-MIBG scintigraphy in idiopathic REM sleep behavior disorder