Journal
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
Volume 50, Issue 6, Pages 577-584Publisher
KARGER
DOI: 10.1159/000521645
Keywords
Dementia with Lewy bodies; Easy Z-score imaging system; REM sleep behavior disorder; Single-photon emission computed tomography; Cingulate island sign
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This study found that easy Z-score imaging system-specific volume-of-interest analysis (SVA) can predict the short-term development of neurodegenerative dementia in patients with idiopathic rapid eye movement sleep behavior disorder (IRBD). This has important implications for clinical trials of disease-modifying therapies.
Introduction: Longitudinal studies have reported that patients with idiopathic rapid eye movement sleep behavior disorder (IRBD) have an increased risk of developing synucleinopathies, such as Parkinson's disease and dementia with Lewy bodies (DLB). Clinical trials of disease-modifying therapies for IRBD patients require suitable biomarkers that can predict the short-term onset of neurodegenerative dementia. Methods: We retrospectively examined if easy Z-score imaging system-specific volume-of-interest analysis (SVA) using brain perfusion single-photon emission computed tomography (SPECT) imaging or the cingulate island sign score can predict the short-term development of neurodegenerative dementia in 30 patients with IRBD. Results: Ten patients (33.3%) who exceeded the thresholds for three indicators (severity, extent, and ratio) were included in an SVA-positive group, while 20 (66.7%) were included in an SVA-negative group. Nine (30.0%) IRBD patients had phenoconversion, of which eight had DLB and one had Parkinson's disease with dementia. In Kaplan-Meier analysis, patients in the SVA-positive group converted to neurodegenerative dementia in a significantly shorter period of time compared to patients in the SVA-negative group. Conclusions: These data suggest that SVA-positive IRBD patients have an increased short-term risk of developing neurodegenerative dementia.
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