Correlation Between RBD And Cognitive Function And Its Brain Mechanism In Parkinson’s Disease

Rapid eye movement sleep behavior disorder(RBD)affects 30-40 % of patients with Parkinson ’s disease(PD),mainly manifested as REM skeletal muscle achalasia accompanied by violence-related dreams.Previous studies have shown that PD with RBD has a higher risk of cognitive impairment over time,especially executive dysfunction.The change of spontaneous neural activity in the prefrontal cortex may indicate the possibility of RBD promoting executive dysfunction.As a new functional imaging method,functional near infrared spectroscopy(f NIRS)can monitor the spontaneous neural activity of the cortex and evaluate the neural mechanism of executive functions changes.Aims 1 : To investigate the brain activation patterns in patients with Parkinson ’s disease(PD)with RBD compared with those without RBD,and to further analyze the correlation between changes in cerebral cortex activity and the severity of RBD.Aims 2 : To investigate the changes of spontaneous neural activity in Parkinson ’s disease(PD)patients with RBD compared with those without RBD.Methods 1 : 50 PD patients were recruited,including 30 PD patients with RBD(PD-RBD+),20 PD patients without RBD(PD-RBD-),and 20 healthy controls(HC).VFT-f NIRS and clinical neuropsychological assessment were used to explore the correlation between PDRBD + and executive function and changes in neural activity.Methods 2 :50 PD patients were recruited,including 30(PD-RBD +)and 20 PD-RBD-,and20 HC.Resting-state f NIRS and clinical neuropsychological assessment were used to explore the spontaneous neural activity changes of PD-RBD+ in prefrontal lobe and frontoparietal network.Results 1:VFT-f NIRS showed that PD-RBD + activation was significantly reduced in multiple channels.Compared with PD-RBD-group,PD-RBD + activation was reduced in bilateral DLPFC : right DLPFC :(CH7.CH9.CH16);compared with HC,PD-RBD was significantly reduced in the right DLPFC(CH7.CH9);The Averaged △Hb02 in right DLPFC(CH7)was negatively correlated with RBDSQ score.Results 2 : Compared with PD-RBD-,PD-RBD + showed decreased functional connectivity between the right DLPFC and FPA,between the right DLPFC,and FPA and FEF.At the same time,compared with the HC group,the functional connectivity in the FPA of the PD-RBD + and PD-RBD-groups was enhanced,and the functional connectivity in the prefrontal lobe of the PD-RBD-group was more significant.Conclusion 1 :1.Compared with PD-RBD +,PD-RBD-decreased activation in bilateral DLPFC and right VLPFC during the task.2.The change of Hb O2 concentration in the right DLPFC was negatively correlated with RBDSQ score.3.Compared with HC,the activation of PD-RBD-in the right DLPFC was decreased.Conclusion 2 :1.The mechanism of PD-RBD + may be related to the neural network within DLPFC,DLPFC and FPA,FPA and FEF.2.Compared with HC,PD have enhanced functional connectivity in the frontal cortex,which may be a compensation for the weakening of the striatum-dopamine system.