Objective: The aim was to investigate the brain functional network alteration /pattern as a measure to identify the conversion from idiopathic rapid eye movement sleep behavior disorder (iRBD) to Parkinson’s disease (PD) and multiple system atrophy (MSA).

Background: IRBD is a prodromal stage of synucleinopathies such as PD and MSA. However, the potential biomarkers to predicting the conversion from iRBD to neurodegeneration remains lacking. The brain functional network alteration/pattern, as an imaging biomarker to detecting and monitoring the different neurodegenerative diseases, has not been investigated yet.

Method: Using the Dosenbach 160 node atlas, we examined resting-state whole -brain functional networks in 96 iRBD, 103PD, 67MSA and 79 healthy controls. Both Network-Based Statistic analyses and large-scale network analyses were conducted to compare the intrinsic functional networks between groups contrasts.

Results: After quality control, 70 iRBD, 86 PD, 58 MSA and 70 healthy controls were included in the final analyses. Compared to healthy controls, iRBD, PD and MSA showed significantly different brain-network patterns. Compared to iRBD, a network with 26 nodes and 29 edges was found significant difference in patients with MSA, while an altered network with 25 nodes and 25 edges was found in PD (Figure 1). Moreover, patients with MSA showed most decreased connectivity in cerebellar and visual networks and increased connectivity in sensorimotor and subcortical networks compared to subjects with iRBD. In contrast, compared to iRBD, patients with PD demonstrated most decreased connectivity in sensorimotor, frontoparietal and subcortical networks, and increased connectivity in visual and default mode networks.

Conclusion: Distinct whole-brain functional network patterns in PD and MSA compared to iRBD, indicating the underlying pathophysiological mechanism between synucleinopathies and providing a potential imaging biomarker of detecting and monitoring the evolution of iRBD.  Further longitudinal studies are needed.

Figure 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/whole-brain-functional-network-signature-reflecting-conversion-of-isolated-rem-sleep-behavior-disorder/