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Rapid eye movement sleep behaviour disorder and striatal dopamine depletion in patients with Parkinson's disease
Author(s) -
Chung S. J.,
Lee Y.,
Lee J. J.,
Lee P. H.,
Sohn Y. H.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13388
Subject(s) - putamen , dopamine transporter , parkinson's disease , dopamine , parkinsonism , rapid eye movement sleep , medicine , striatum , levodopa , rem sleep behavior disorder , movement disorders , disease , endocrinology , eye movement , dopaminergic , ophthalmology
Background and purpose Rapid eye movement sleep behaviour disorder ( RBD ) is related to striatal dopamine depletion. This study was performed to confirm whether clinically probable RBD (cp RBD ) in patients with Parkinson's disease ( PD ) is associated with a specific pattern of striatal dopamine depletion. Methods A prospective survey was conducted using the RBD Screening Questionnaire ( RBDSQ ) in 122 patients with PD who had undergone dopamine transporter ( DAT ) positron emission tomography scan. Results Patients with cp RBD (RBDSQ ≥ 7) exhibited greater motor deficits, predominantly in the less‐affected side and axial symptoms, and were prescribed higher levodopa‐equivalent doses at follow‐up than those without cp RBD (RBDSQ ≤ 4), despite their similar disease and treatment durations. Compared to patients without cp RBD , those with cp RBD showed lower DAT activities in the putamen, particularly in the less‐affected side in all putaminal subregions, and a tendency to be lower in the ventral striatum. In addition, greater motor deficits in patients with cp RBD than in those without cp RBD remained significant after controlling for DAT binding in the putamen and other confounding variables. Conclusions These results demonstrated that the presence of RBD in patients with PD is associated with different patterns of both motor deficit distribution and striatal DAT depletion, suggesting that the presence of RBD represents a distinct PD subtype with a malignant motor parkinsonism.