title: Voxel-based magnetic resonance imaging study of structural brain changes in patients with idiopathic REM sleep behavior disorder.
abstract: OBJECTIVE
  Rapid eye movement (REM) sleep behavior disorder (RBD) is considered to result from dysfunction of the brain stem structures that regulate REM sleep. In this study, we investigated structural brain changes using magnetic resonance imaging (MRI) in patients with idiopathic RBD (iRBD) to determine structural brain alterations associated with the disorder.
  
  
  METHODS
  Voxel-based MRI morphometry was applied to 20 patients with iRBD and findings were compared with those from 18 age-matched controls.
  
  
  RESULTS
  Compared with the controls, the patients with iRBD had significant gray matter volume reduction in the anterior lobes of the right and left cerebellum, tegmental portion of the pons, and left parahippocampal gyrus.
  
  
  CONCLUSIONS
  The present study provides in vivo evidence suggesting that structural lesions of the brain stem are responsible for the occurrence of iRBD. In addition, the pattern of gray matter loss is consistent with morphological changes commonly observed in patients with Lewy body disease and multiple system atrophy, indicating that iRBD can share a common morphological abnormality with alpha-synucleinopathies.
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. h-hanyu@tokyo-med.ac.jp
authors.forename: Haruo
authors.initials: H
authors.lastname: Hanyu
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Sakurai
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kanetaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Taeko
authors.initials: T
authors.lastname: Sasai
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology