title: The Role of the Serotonergic System in REM Sleep Behavior Disorder.
abstract: OBJECTIVE
  REM sleep behavior disorder (RBD) can be induced by antidepressants, especially serotonin reuptake inhibitors (SSRI), thus a role of the serotonergic system in the pathogenesis of RBD has been proposed. However, the serotonergic system integrity in idiopathic RBD (iRBD) is still unknown. We aimed to study brain stem serotonergic system integrity, by means of (123)I-FP-CIT-SPECT, in a group of iRBD patients as compared to normal subjects.
  
  
  METHODS
  Single-center, prospective observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twenty iRBD outpatients and 23 age-matched normal controls.
  
  
  RESULTS
  The diagnosis of RBD was determined clinically and confirmed by means of overnight, laboratory-based video-polysomnography. Both iRBD patients and normal subjects underwent (123)I-FP-CIT-SPECT as a marker of dopamine transporter (DAT) at basal ganglia level and of serotonin transporter (SERT) at brainstem and thalamus levels. (123)I-FP-CIT-SPECT images were analyzed and compared between iRBD patients and controls by means of both region of interest analysis at basal ganglia, midbrain, pons and thalamus levels, and voxel-based analysis, taking into account age and the use of SSRI as confounding factors. No difference in (123)I-FP-CIT-SPECT specific to nondisplaceable binding ratios (SBR) values was found between iRBD and normal subjects at brainstem and thalamus levels while iRBD patients showed lower SBR values in all basal ganglia nuclei (P < 0.0001) compared to controls.
  
  
  CONCLUSIONS
  These results suggest that the serotonergic system is not directly involved in RBD pathogenesis while confirming nigro-striatal dopaminergic deafferentation in iRBD.
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Arnaldi
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Famà
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Carli
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Ferrara
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Agnese
authors.initials: A
authors.lastname: Picco
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Accardo
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Primavera
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
authors.affiliation: Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Nobili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003342:Corpus Striatum / Q000378:metabolism; D004298:Dopamine / Q000378:metabolism; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D020187:REM Sleep Behavior Disorder / Q000503:physiopathology*; D012701:Serotonin / Q000502:physiology*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes; D014741:Video Recording
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D050486:Serotonin Plasma Membrane Transport Proteins; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane; D012701:Serotonin; D004298:Dopamine
keywords: RBD; SPECT; serotonin
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