title: Brainstem proton magnetic resonance spectroscopy in idopathic REM sleep behavior disorder.
abstract: OBJECTIVE
  Rapid-eye-movement (REM) sleep behavior disorder (RBD) is thought to result from a dysfunction of the brainstem structures that regulate physiologic REM sleep muscle atonia. Proton magnetic resonance spectroscopy (1H-MRS) is a noninvasive method that allows detection of in vivo neuronal dysfunction in localized brain areas. The aim of our study was to investigate whether 1H-MRS can detect brainstem abnormalities in patients with idiopathic RBD.
  
  
  METHODS
  1H-MRS centered on the midbrain and the pontine tegmentum was acquired in 15 patients with idiopathic RBD and 15 control subjects matched for age and sex.
  
  
  METHODS
  University hospital sleep laboratory center.
  
  
  METHODS
  Fifteen untreated patients with chronic RBD diagnosed by history and video-polysomnography, normal neurologic examination, and normal cranial MRI. Fifteen healthy controls with no sleep complaints and normal polysomnography and brain MRI.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  The metabolic peaks detectable with 1H-MRS, N-acetylaspartate (NAA), creatine-phosphocreatine (Cr), choline-containing compounds (Cho) and myoinositol (mI), and the ratios of NAA, Cho and ml to Cr were evaluated both in the midbrain and pontine tegmentum. No significant differences in N-acetylaspartate/creatine, choline/creatine and myoinosito/creatine ratios were found between patients and controls.
  
  
  CONCLUSIONS
  The results do not suggest that marked mesopontine neuronal loss or 1H-MRS detectable metabolic disturbances occur in idiopathic RBD.
authors.affiliation: Neurology Service, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain. airanzo@clinic.ub.es
authors.forename: Alex
authors.initials: A
authors.lastname: Iranzo
authors.forename: Joan
authors.initials: J
authors.lastname: Santamaria
authors.forename: Jesús
authors.initials: J
authors.lastname: Pujol
authors.forename: Angel
authors.initials: A
authors.lastname: Moreno
authors.forename: Joan
authors.initials: J
authors.lastname: Deus
authors.forename: Eduard
authors.initials: E
authors.lastname: Tolosa
mesh_terms: D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001933:Brain Stem / Q000002:abnormalities / Q000378:metabolism / Q000503:physiopathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004576:Electromyography; D005260:Female; D006801:Humans; D007294:Inositol / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008636:Mesencephalon / Q000378:metabolism; D008875:Middle Aged; D010725:Phosphocreatine / Q000378:metabolism; D017286:Polysomnography; D011149:Pons / Q000378:metabolism; D011446:Prospective Studies; D011522:Protons; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D012720:Severity of Illness Index; D012895:Sleep, REM / Q000502:physiology*
chemical_list: D011522:Protons; D010725:Phosphocreatine; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline