Amplitude Of Low Frequency Fluctuation In Patients With Parkinson’s Disease And REM Sleep Behavior Disorder:a Resting-State Functional Magnetic Resonance Imaging Study

Objective:Rapid eye movement (REM) sleep behavior disorder (RBD) is a common sleep disorder in patients with Parkinson’s disease (PD). The presence of clinical RBD may be related to more severe motor symptoms, cardiac autonomic dysfunction, and development of dementia in PD patients. The aim of the study is to investigate the features of brain activity in PD patients with RBD, through amplitude of low frequency fluctuation (ALFF) technology of resting-state functional magnetic resonance imaging (rsfMRI), which will improve the understanding of pathophysiological basis in PD patients with RBD.Method:Eighteen PD patients with RBD (PD-RBD), sixteen PD patients without RBD (PD-nRBD) and nineteen well-matched normal controls (NCs) were scanned with rsfMRI. The fMRI data were processed by statistical parametric mapping (SPM8) soft and REST soft. We also extracted the value of ALFF. Two sample t-test was used to detect the brain regions with abnormal ALFF.Result:Findings show that PD-RBD patients had significantly lower ALFF in the premotor cortex, the supplementary motor area (SMA) and the primary motor cortex and higher ALFF in the left lateral inferior temporal gyrus compared with PD-nRBD patients. In addition, when compared with NCs, PD-nRBD patients showed lower ALFF in left caudate and putamen, left cerebellum anterior and posterior lobe and higher ALFF in prefrontal cortex (PFC).Conclusion:The dysfunction of the motor cortex and inferior temporal gyrus might relate to more severe motor symptoms and cognitive function in PD-RBD. Both of the results provide a probable functional proof to the clinical manifestation of PD-RBD. In addition, the abnormal brain activity of striatum, cerebellum and PFC might relate to the pathological and compensatory mechanism in PD.