title: Brain Atrophy of Secondary REM-Sleep Behavior Disorder in Neurodegenerative Disease.
abstract: Rapid eye movement sleep behavior disorder (RBD) may present as an early manifestation of an evolving neurodegenerative disorder with alpha-synucleinopathy.
  
  
  
  We investigated that dementia with RBD might show distinctive cortical atrophic patterns.
  
  
  
  A total of 31 patients with idiopathic Parkinson's disease (IPD), 23 with clinically probable Alzheimer's disease (AD), and 36 healthy controls participated in this study. Patients with AD and IPD were divided into two groups according to results of polysomnography and rated with a validated Korean version of the RBD screening questionnaire (RBDSQ-K), which covers the clinical features of RBD. Voxel-based morphometry was adapted for detection of regional brain atrophy among groups of subjects.
  
  
  
  Scores on RBDSQ-K were higher in the IPD group (3.54 ± 2.8) than in any other group (AD, 2.94 ± 2.4; healthy controls, 2.31 ± 1.9). Atrophic changes according to RBDSQ-K scores were characteristically in the posterior part of the brain and brain stem, including the hypothalamus and posterior temporal region including the hippocampus and bilateral occipital lobe. AD patients with RBD showed more specialized atrophic patterns distributed in the posterior and inferior parts of the brain including the bilateral temporal and occipital cortices compared to groups without RBD. The IPD group with RBD showed right temporal cortical atrophic changes.
  
  
  
  The group of patients with neurodegenerative diseases and RBD showed distinctive brain atrophy patterns, especially in the posterior and inferior cortices. These results suggest that patients diagnosed with clinically probable AD or IPD might have mixed pathologies including α-synucleinopathy.
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Hyung Kyun
authors.initials: HK
authors.lastname: Im
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Juhan
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.|Clinical Neuroscience Center, Seoul National University, Bundang Hospital, Seongnam, Korea.
authors.forename: Jee-Young
authors.initials: JY
authors.lastname: Han
authors.affiliation: Center for Brain Health, Department of Psychiatry, NYU School of Medicine, New York, NY, USA.
authors.forename: Mony
authors.initials: M
authors.lastname: de Leon
authors.affiliation: Center for Brain Health, Department of Psychiatry, NYU School of Medicine, New York, NY, USA.
authors.forename: Anup
authors.initials: A
authors.lastname: Deshpande
authors.affiliation: Department of Radiology, Konkuk University Hospital, Seoul, Korea.
authors.forename: Won-Jin
authors.initials: WJ
authors.lastname: Moon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000000981:diagnostic imaging; D001284:Atrophy / Q000000981:diagnostic imaging / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000000981:diagnostic imaging / Q000209:etiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D051844:alpha-Synuclein / Q000235:genetics
chemical_list: D051844:alpha-Synuclein
keywords: Brain atrophy; RBD screening questionnaire; REM sleep disorder; dementia; voxel-based morphometry