The Parkinson’s Disease Progression Neuroimaging Initiative

The Parkinson’s Disease Progressive Neuroimaging Initiative (PDPNI) is a longitudinal observational clinical study. In PDPNI, the clinical and imaging data of patients diagnosed with Parkinsonian syndromes and Idiopathic rapid eye movement sleep behavior disorder (RBD) were longitudinally followed every two years, aiming to identify progression biomarkers of Parkinsonian syndromes through functional imaging modalities including FDG-PET, DAT-PET imaging, ASL MRI, and fMRI, as well as the treatment conditions, clinical symptoms, and clinical assessment results of patients. From February 2012 to March 2019, 224 subjects (including 48 healthy subjects and 176 patients with confirmed PDS) have been enrolled in PDPNI. The detailed clinical information and clinical assessment scores of all subjects were collected by neurologists from Huashan Hospital, Fudan University. All subjects enrolled in PDPNI were scanned with 18F-FDG PET, 11C-CFT PET, and MRI scan sequence. All data were collected in strict accordance with standardized data collection protocols.

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Associations between probable REM sleep behavior disorder, olfactory disturbance, and clinical symptoms in Parkinson’s disease: A multicenter cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0247443 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247443

Author(s):

Mutsumi Iijima ◽

Yasuyuki Okuma ◽

Keisuke Suzuki ◽

Fumihito Yoshii ◽

Shigeru Nogawa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Clinical Symptoms ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Cross Sectional ◽

Sleep Behavior

Background Rapid eye movement sleep behavior disorder (RBD) and olfactory dysfunction are useful for early diagnosis of Parkinson’s disease (PD). RBD and severe olfactory dysfunction are also regarded as risk factors for cognitive impairment in PD. This study aimed to assess the associations between RBD, olfactory function, and clinical symptoms in patients with PD. Methods The participants were 404 patients with non-demented PD. Probable RBD (pRBD) was determined using the Japanese version of the RBD screening questionnaire (RBDSQ-J) and the RBD Single-Question Screen (RBD1Q). Olfactory function was evaluated using the odor identification test for Japanese. Clinical symptoms were evaluated using the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts I–IV. Results In total, 134 (33.2%) patients indicated a history of pRBD as determined by the RBD1Q and 136 (33.7%) by the RBDSQ-J based on a cutoff value of 6 points. Moreover, 101 patients were diagnosed as pRBD by both questionnaires, 35 by the RBDSQ-J only, and 33 by the RBD1Q only. The MDS-UPDRS parts I–III scores were significantly higher and disease duration significantly longer in the pRBD group. pRBD was significantly associated with male gender and the MDS-UPDRS part I score. The olfactory identification function was significantly reduced in the pRBD group. Conclusions About 33% of the patients with PD had pRBD based on the questionnaires, and both motor and non-motor functions were significantly decreased in these patients. These results suggest that more extensive degeneration occurred in patients with non-demented PD with RBD.

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Parkinson Disease–Related Brain Metabolic Patterns and Neurodegeneration in Isolated REM Sleep Behavior Disorder

Neurology ◽

10.1212/wnl.0000000000012228 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012228

Author(s):

Jung Hwan Shin ◽

Jee-Young Lee ◽

Yu-Kyeong Kim ◽

Eun Jin Yoon ◽

Heejung Kim ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Eye Movement ◽

Fdg Pet ◽

Rating Scale ◽

De Novo ◽

Behavior Disorder ◽

Rapid Eye Movement ◽

Rapid Eye Movement Sleep ◽

Sleep Behavior

ABSTRACTObjective:To elucidate the role of Parkinson’s disease (PD)-related brain metabolic patterns as a biomarker in isolated rapid-eye-movement sleep behavior disorder (iRBD) for future disease conversion.Method:This is a prospective cohort study consisting of 30 iRBD patients, 25 de novo PD patients with a premorbid history of RBD, 21 long-standing PD patients on stable treatment and 24 healthy controls. iRBD group was longitudinally followed up. All participants underwent 18F-Fluorodeoxyglucose (FDG) PET and were evaluated with olfaction, cognition, and the Movement disorders society-Unified PD Rating Scale (MDS-UPDRS) at baseline. From FDG-PET scans, we derived metabolic patterns from the long-standing PD group (PD-RP) and de novo PD group with RBD (dnPDRBD-RP). Subsequently, we calculated the PD-RP and dnPDRBD-RP scores in iRBD patients. We validated the metabolic patterns in each PD group and separate iRBD cohort (n=14).Result:The two patterns significantly correlated with each other and were spatially overlapping yet distinct. The MDS-UPDRS motor scores significantly correlated with PD-RP (p = 0.013) but not with dnPDRBD-RP (p = 0.076). In contrast, dnPDRBD-RP correlated with olfaction in butanol threshold test (p = 0.018) in iRBD subjects, but PD-RP did not (p = 0.21). High dnPDRBD-RP in iRBD patients predicted future phenoconversion with all cut-off ranges from 1.5 to 3 standard deviations of the control value, whereas predictability of PD-RP was only significant in a partial range of cut-off.Conclusion:The dnPDRBD-RP is an efficient neuroimaging biomarker that reflects prodromal features of PD and predicts phenoconversion in iRBD that can be applied individually.Classification of Evidence:This study provides Class IV evidence that a de novo Parkinson's disease pattern on FDG-PET predict future conversion to neurodegenerative disease in patients with isolated rapid-eye-movement sleep behavior disorder (iRBD).

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Occipital hypometabolism on [ 18 F]-FDG PET scans in patients with idiopathic REM sleep behavior disorder is less prominent than those of patients with Parkinson’s disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2017.11.249 ◽

2018 ◽

Vol 46 ◽

pp. e72

Author(s):

K. Kashihara ◽

M. Ban ◽

T. Baba ◽

A. Takeda

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rem Sleep ◽

Fdg Pet ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Sleep Behavior ◽

Pet Scans

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Development and Validation of a Prognostic Model for Cognitive Impairment in Parkinson’s Disease With REM Sleep Behavior Disorder

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.703158 ◽

2021 ◽

Vol 13 ◽

Author(s):

Fangzheng Chen ◽

Yuanyuan Li ◽

Guanyu Ye ◽

Liche Zhou ◽

Xiaolan Bian ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Prognostic Model ◽

External Validation ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Imaging Data ◽

Sleep Behavior ◽

Validation Set

The presentation and progression of Parkinson’s disease (PD) are not uniform, but the presence of rapid eye movement sleep behavior disorder (RBD) in PD patients may indicate a worse prognosis than isolated PD. Increasing evidence suggests that patients with comorbid PD and RBD (PD-RBD) are more likely to develop cognitive impairment (CI) than those with isolated PD; however, the predictors of CI in PD-RBD patients are not well understood. This study aimed to develop a prognostic model for predicting mild cognitive impairment (MCI) in PD-RBD patients. The data of PD-RBD patients were extracted from the Parkinson’s Progression Markers Initiative study (PPMI), and the sample was randomly divided into a training set (n = 96) and a validation set (n = 24). PD-MCI as defined by the level II Movement Disorder Society (MDS) diagnostic criteria was the outcome of interest. The demographic features, clinical assessments, dopamine transporter (DAT) imaging data, cerebrospinal fluid (CSF) analyses and genetic data of PD patients were considered candidate predictors. We found that performance on the University of Pennsylvania Smell Identification Test (UPSIT), the mean signal and asymmetry index of the putamen on DAT imaging, p-tau/α-syn and p-tau in CSF, and rs55785911 genotype were predictors of PD-MCI in PD-RBD patients. A C-index of 0.81 was obtained with this model, and a C-index of 0.73 was obtained in the validation set. Favorable results of calibrations and decision curve analysis demonstrated the efficacy and feasibility of this model. In conclusion, we developed a prognostic model for predicting MCI in PD-RBD patients; the model displayed good discrimination and calibration and may be a convenient tool for clinical application. Larger samples and external validation sets are needed to validate this model.

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