title: The coeruleus/subcoeruleus complex in idiopathic rapid eye movement sleep behaviour disorder.
abstract: Idiopathic rapid eye movement sleep behaviour disorder is characterized by nocturnal violence, increased muscle tone during rapid eye movement sleep and the lack of any other neurological disease. However, idiopathic rapid eye movement sleep behaviour disorder can precede parkinsonism and dementia by several years. Using 3 T magnetic resonance imaging and neuromelanin-sensitive sequences, we previously found that the signal intensity was reduced in the locus coeruleus/subcoeruleus area of patients with Parkinson's disease and rapid eye movement sleep behaviour disorder. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex with neuromelanin-sensitive imaging in 21 patients with idiopathic rapid eye movement sleep behaviour disorder and compared the results with those from 21 age- and gender-matched healthy volunteers. All subjects underwent a clinical examination, motor, cognitive, autonomous, psychological, olfactory and colour vision tests, and rapid eye movement sleep characterization using video-polysomnography and 3 T magnetic resonance imaging. The patients more frequently had preclinical markers of alpha-synucleinopathies, including constipation, olfactory deficits, orthostatic hypotension, and subtle motor impairment. Using neuromelanin-sensitive imaging, reduced signal intensity was identified in the locus coeruleus/subcoeruleus complex of the patients with idiopathic rapid eye movement sleep behaviour. The mean sensitivity of the visual analyses of the signal performed by neuroradiologists who were blind to the clinical diagnoses was 82.5%, and the specificity was 81% for the identification of idiopathic rapid eye movement sleep behaviour. The results confirm that this complex is affected in idiopathic rapid eye movement sleep behaviour (to the same degree as it is affected in Parkinson's disease). Neuromelanin-sensitive imaging provides an early marker of non-dopaminergic alpha-synucleinopathy that can be detected on an individual basis.
authors.affiliation: Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Ecole Normale Supérieure, Paris, France Sorbonne University, UPMC Paris-6, Paris, France.
authors.forename: Mickael
authors.initials: M
authors.lastname: Ehrminger
authors.affiliation: Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Latimier
authors.affiliation: Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France.
authors.forename: Nadya
authors.initials: N
authors.lastname: Pyatigorskaya
authors.affiliation: Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Garcia-Lorenzo
authors.affiliation: Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France.
authors.forename: Smaranda
authors.initials: S
authors.lastname: Leu-Semenescu
authors.affiliation: Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Vidailhet
authors.affiliation: Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lehericy
authors.affiliation: Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France INSERM AP-HP, CIC-1421, University Hospital, Paris, 75013, France isabelle.arnulf@aphp.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008125:Locus Coeruleus / Q000473:pathology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D011795:Surveys and Questionnaires
keywords: Lewy bodies; MRI; REM sleep behaviour disorder; locus subcoeruleus; neuromelanin-sensitive imaging