scholarly journals Reduced striatal vesicular monoamine transporter 2 in REM sleep behavior disorder: imaging prodromal parkinsonism

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Leah C. Beauchamp ◽  
Victor L. Villemagne ◽  
David I. Finkelstein ◽  
Vincent Doré ◽  
Ashley I. Bush ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Time Window ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Vesicular Monoamine Transporter ◽  
Motor Symptoms ◽  
Monoamine Transporter ◽  
Sleep Behavior ◽  
Nigrostriatal Degeneration ◽  
Non Motor Symptoms

Abstract Motor deficits in parkinsonism are caused by degeneration of dopaminergic nigral neurons. The success of disease-modifying therapies relies on early detection of the underlying pathological process, leading to early interventions in the disease phenotype. Healthy (n = 16), REM sleep behavior disorder (RBD) (n = 14), dementia with Lewy bodies (n = 10), and Parkinson’s disease (PD) (n = 20) participants underwent 18F-AV133 vesicular monoamine transporter type-2 (VMAT2) PET to determine the integrity of the nigrostriatal pathway. Clinical, neurophysiological and neuropsychological testing was conducted to assess parkinsonian symptoms. There was reduced VMAT2 levels in RBD participants in the caudate and putamen, indicating nigrostriatal degeneration. RBD patients also presented with hyposmia and anxiety, non-motor symptoms associated with parkinsonism. 18F-AV133 VMAT2 PET allows identification of underlying nigrostriatal degeneration in RBD patients. These findings align with observations of concurrent non-motor symptoms in PD and RBD participants of the Parkinson’s Progression Markers Initiative. Together, these findings suggest that RBD subjects have prodromal parkinsonism supporting the concept of conducting neuroprotective therapeutic trials in RBD-enriched cohorts. Ongoing longitudinal follow-up of these subjects will allow us to determine the time-window of clinical progression.

scholarly journals Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Petr Dušek ◽  
Veronika Lorenzo y Losada Ibarburu ◽  
Ondrej Bezdicek ◽  
Irene Dall’antonia ◽  
Simona Dostálová ◽  
...  
Keyword(s):  
Dopamine Transporter ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Motor Symptoms ◽  
Sleep Behavior ◽  
Binding Ratio ◽  
Dat Spect ◽  
Non Motor Symptoms

Abstract 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.

scholarly journals Parkinson’s disease and REM sleep behavior disorder result in increased non-motor symptoms

2014 ◽  
Vol 15 (8) ◽  
pp. 959-966 ◽  
Author(s):  
Ariel B. Neikrug ◽  
Julie A. Avanzino ◽  
Lianqi Liu ◽  
Jeanne E. Maglione ◽  
Loki Natarajan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Motor Symptoms ◽  
Sleep Behavior ◽  
Non Motor Symptoms

Various Motor and Non-Motor Symptoms in Early Multiple System Atrophy

2019 ◽  
Vol 19 (5-6) ◽  
pp. 238-243 ◽  
Author(s):  
Yu Jin Jung ◽  
Han-Joon Kim ◽  
Dallah Yoo ◽  
Ji-Hyun Choi ◽  
Jin Hee Im ◽  
...  
Keyword(s):  
Multiple System Atrophy ◽  
Disease Duration ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Accurate Diagnosis ◽  
Motor Symptoms ◽  
Red Flags ◽  
Sleep Behavior ◽  
Autonomic Dysfunctions ◽  
Non Motor Symptoms

Background: Multiple system atrophy (MSA) patients pre­sent a variety of symptoms other than autonomic dysfunctions, parkinsonism, and cerebellar ataxia. The aim of this study was to evaluate the frequency of various motor and non-motor symptoms including so-called “red flags” in patients with early MSA and to determine whether the frequency of these symptoms was different between the parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes. Methods: Sixty-one probable or possible MSA patients with disease duration of 3 years or less were included. Patients were classified into MSA-P, MSA-C, and MSA-PC. The frequency of 13 features including various motor and non-motor symptoms that commonly occur in MSA was assessed. Results: Dysarthria was the most prevalent feature (98.4%) followed by sexual dysfunction (95.1%). Probable REM sleep behavior disorder was present in 90.2%. The frequency of constipation (82.0%), dysphagia (68.9%), and snoring (70.5%) was also high. Stridor was present in 42.6% and more common in MSA-C than in MSA-P. Conclusions: Increasing awareness of various motor and non-motor symptoms may assist clinicians to make an early, accurate diagnosis and to improve management of patients with MSA. We suggest that the diagnostic accuracy can be improved if these features are appropriately reflected in the new diagnostic criteria for MSA.

scholarly journals Can Corticomuscular Coherence Differentiate between REM Sleep Behavior Disorder with or without Parkinsonism?

2021 ◽  
Vol 10 (23) ◽  
pp. 5585
Author(s):  
Gyeong Seon Choi ◽  
Ji Young Yun ◽  
Sungeun Hwang ◽  
Song E. Kim ◽  
Jeong-Yeon Kim ◽  
...  
Keyword(s):  
Clinical Features ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Stages ◽  
Motor Symptoms ◽  
Limb Muscle ◽  
Sleep Behavior ◽  
Distinctive Features ◽  
Muscle Atonia

REM sleep behavior disorder (RBD) could be a predictor of Parkinsonism even before development of typical motor symptoms. This study aims to characterize clinical features and corticomuscular and corticocortical coherence (CMC and CCC, respectively) during sleep in RBD patients with or without Parkinsonism. We enrolled a total of 105 subjects, including 20 controls, 54 iRBD, and 31 RBD+P patients, patients who were diagnosed as idiopathic RBD (iRBD) and RBD with Parkinsonism (RBD+P) in our neurology department. We analyzed muscle atonia index (MAI) and CMC between EEG and chin/limb muscle electromyography (EMG) and CCC during different sleep stages. Although differences in the CMC of iRBD group were observed only during REM sleep, MAI differences between groups were noted during both REM and NREM N2 stage sleep. During REM sleep, CMC was higher and MAI was reduced in iRBD patients compared to controls (p = 0.001, p < 0.001, respectively). Interestingly, MAI was more reduced in RBD+P compared to iRBD patients. In comparison, CCC was higher in iRBD patients compared to controls whereas CCC was lower in RBD+P groups compared to control and iRBD groups in various frequency bands during both NREM N2 and REM sleep stages. Among them, increased CMC during REM sleep revealed correlation between clinical severities of RBD symptoms. Our findings indicate that MAI, CMC, and CCC showed distinctive features in iRBD and RBD+P patients compared to controls, suggesting potential usefulness to understand possible links between these diseases.

scholarly journals A Stage-Based Approach to Therapy in Parkinson’s Disease

Biomolecules ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. 388 ◽  
Author(s):  
Claudia Carrarini ◽  
Mirella Russo ◽  
Fedele Dono ◽  
Martina Di Pietro ◽  
Marianna G. Rispoli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Motor Symptoms ◽  
Pharmacological Management ◽  
Sleep Behavior ◽  
Heavy Burden ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is a neurodegenerative disorder that features progressive, disabling motor symptoms, such as bradykinesia, rigidity, and resting tremor. Nevertheless, some non-motor symptoms, including depression, REM sleep behavior disorder, and olfactive impairment, are even earlier features of PD. At later stages, apathy, impulse control disorder, neuropsychiatric disturbances, and cognitive impairment can present, and they often become a heavy burden for both patients and caregivers. Indeed, PD increasingly compromises activities of daily life, even though a high variability in clinical presentation can be observed among people affected. Nowadays, symptomatic drugs and non-pharmaceutical treatments represent the best therapeutic options to improve quality of life in PD patients. The aim of the present review is to provide a practical, stage-based guide to pharmacological management of both motor and non-motor symptoms of PD. Furthermore, warning about drug side effects, contraindications, as well as dosage and methods of administration, are highlighted here, to help the physician in yielding the best therapeutic strategies for each symptom and condition in patients with PD.

scholarly journals SLEEP DISORDERS IN PARKINSON’S DISEASE

2019 ◽  
Vol 72 (3) ◽  
pp. 425-431
Author(s):  
Magdalena Doręgowska ◽  
Monika Rudzińska-Bar
Keyword(s):  
Sleep Apnea Syndrome ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Stages ◽  
Motor Symptoms ◽  
Sleep Behavior ◽  
Sleep Physiology ◽  
Obstructive Sleep ◽  
Sleeping Problems ◽  
Non Motor Symptoms

Sleep disorder are common non-motor symptoms in Parkinson`s disease (PD). They can be found in different sleep stages or appear during the daytime. They correlate with faster progression of motor problems and lower quality of a patient’s life. Sleep physiology, different sleep dysfunction such as: RBD-REM sleep behavior disorder, EDS – excessive daytime sleepiness, insomnia, OSAS-obstructive sleep apnea syndrome, and their clinical manifestation have been presented in this review. Diagnostic and therapy possibilities have been summarized as well. Particular attention has also been paid to the coexistence of various non-motor symptoms such as pain, depression or nocturia, and their correlations with sleeping problems.

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