Validation of the REM behaviour disorder phenoconversion-related pattern in an independent cohort

Neurol Sci. 2023 Sep;44(9):3161-3168. doi: 10.1007/s10072-023-06829-2. Epub 2023 May 4.

Abstract

Background: A brain glucose metabolism pattern related to phenoconversion in patients with idiopathic/isolated REM sleep behaviour disorder (iRBDconvRP) was recently identified. However, the validation of the iRBDconvRP in an external, independent group of iRBD patients is needed to verify the reproducibility of such pattern, so to increase its importance in clinical and research settings. The aim of this work was to validate the iRBDconvRP in an independent group of iRBD patients.

Methods: Forty iRBD patients (70 ± 5.59 years, 19 females) underwent brain [18F]FDG-PET in Seoul National University. Thirteen patients phenoconverted at follow-up (7 Parkinson disease, 5 Dementia with Lewy bodies, 1 Multiple system atrophy; follow-up time 35 ± 20.56 months) and 27 patients were still free from parkinsonism/dementia after 62 ± 29.49 months from baseline. We applied the previously identified iRBDconvRP to validate its phenoconversion prediction power.

Results: The iRBDconvRP significantly discriminated converters from non-converters iRBD patients (p = 0.016; Area under the Curve 0.74, Sensitivity 0.69, Specificity 0.78), and it significantly predicted phenoconversion (Hazard ratio 4.26, C.I.95%: 1.18-15.39).

Conclusions: The iRBDconvRP confirmed its robustness in predicting phenoconversion in an independent group of iRBD patients, suggesting its potential role as a stratification biomarker for disease-modifying trials.

Keywords: Alpha-synucleinopathies; Brain metabolic pattern; Dementia with Lewy bodies; Parkinson’s disease; REM behaviour disorder; [18F]FDG-PET.

MeSH terms

  • Brain / diagnostic imaging
  • Brain / metabolism
  • Female
  • Humans
  • Parkinson Disease* / metabolism
  • Parkinsonian Disorders* / diagnostic imaging
  • Parkinsonian Disorders* / metabolism
  • REM Sleep Behavior Disorder* / diagnostic imaging
  • Reproducibility of Results