Journal
SLEEP MEDICINE
Volume 68, Issue -, Pages 31-34Publisher
ELSEVIER
DOI: 10.1016/j.sleep.2019.09.008
Keywords
Idiopathic REM sleep behavior disorder (RBD); Transcranial sonography; Substantia nigra; Hyperechogenicity; Odor stick identification test for Japanese (OSIT-J); Lewy body disease
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Background: We examined the relationship between baseline substantia nigra (SN) echogenicity on transcranial sonography (TCS) images and medium-to long-term developments of Parkinson's disease (PD) and dementia with Lewy bodies (DLB) in idiopathic RBD (IRBD) patients. Methods: From 2007-2009, TCS and odor identification tests were performed in 34 consecutive IRBD patients (67.9 +/- 6.1 years). A medical chart review was conducted in August 2019 to investigate the development of PD or DLB. Results: Of the 34 IRBD patients, 14 (41.2%) showed SN hyperechogenicity (SN+) on TCS at baseline. There were no significant differences in age, Unified Parkinson's Disease Rating Scale (UPDRS) score, Mini-Mental State Exam (MMSE) score, or odor identification (OSIT-J) score between the SN+ and SN normoechogenicity (SN-) groups at baseline. The phenoconversion rate was 57.4% (n = 8) in the SN+ group (mean 5.8 years from baseline TCS), and 25.0% (n = 5) in the SN- group (mean 8.6 years from baseline TCS). Of those with phenoconversions, there were five PD patients and three DLB patients in the SN+ group, and one PD patient and four DLB patients in the SN- group. The SN+ group had a higher estimated risk for disease development than the SN- group. The coexistence of SN+ with functional anosmia may predict a short-term Lewy body disease onset risk. Conclusion: A single baseline TCS for IRBD patients may be a suitable test for screening and predicting groups at high-risk for developing PD or DLB. This may help to select appropriate IRBD patients in clinical trials for disease modifying therapy to prevent progression to PD or DLB. (C) 2019 Elsevier B.V. All rights reserved.
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