Brainstem proton magnetic resonance spectroscopy in idopathic REM sleep behavior disorder.
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.
Iranzo
Alex
A
Neurology Service, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain. airanzo@clinic.ub.es
Santamaria
Joan
J
Pujol
Jesús
J
Moreno
Angel
A
Deus
Joan
J
Tolosa
Eduard
E
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*
D011522:Protons; D010725:Phosphocreatine; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline