Gait Analysis and Magnetic Resonance Imaging Characteristics in Patients with Isolated Rapid Eye Movement Sleep Behavior Disorder

Author:

Sarasso Elisabetta123,Gardoni Andrea1,Marelli Sara24,Balestrino Roberta256,Zenere Lucia1,Castelnuovo Alessandra24,Malcangi Massimo7,Basaia Silvia1ORCID,Grassi Andrea12,Tettamanti Andrea28,Canu Elisa1,Ferini‐Strambi Luigi24,Filippi Massimo12579ORCID,Agosta Federica127ORCID

Affiliation:

1. Neuroimaging Research Unit, Division of Neuroscience IRCCS San Raffaele Scientific Institute Milan Italy

2. Vita‐Salute San Raffaele University Milan Italy

3. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health University of Genoa Genoa Italy

4. Sleep Disorders Center, Division of Neuroscience IRCCS San Raffaele Scientific Institute Milan Italy

5. Neurorehabilitation Unit IRCCS San Raffaele Scientific Institute Milan Italy

6. Neurosurgery and Gamma Knife Radiosurgery Unit IRCCS Ospedale San Raffaele Milan Italy

7. Neurology Unit IRCCS San Raffaele Scientific Institute Milan Italy

8. Department of Rehabilitation and Functional Recovery IRCCS San Raffaele Scientific Institute Milan Italy

9. Neurophysiology Service IRCCS San Raffaele Scientific Institute Milan Italy

Abstract

AbstractBackgroundIsolated rapid eye movement sleep behavioral disorder (iRBD) can precede neurodegenerative diseases. There is an urgent need for biomarkers to aid early intervention and neuroprotection.ObjectiveThe aim is to assess quantitative motor, cognitive, and brain magnetic resonance imaging (MRI) characteristics in iRBD patients.MethodsThirty‐eight polysomnography‐confirmed iRBD patients and 28 age‐ and sex‐matched healthy controls underwent clinical, cognitive, and motor functional evaluations, along with brain MRI. Motor tasks included nine‐hole peg test, five‐times‐sit‐to‐stand test, timed‐up‐and‐go test, and 4‐meter walking test with and without cognitive dual task. Quantitative spatiotemporal gait parameters were obtained using an optoelectronic system. Brain MRI analysis included functional connectivity (FC) of the main resting‐state networks, gray matter (GM) volume using voxel‐based morphometry, cortical thickness, and deep GM and brainstem volumes using FMRIB's Integrated Registration and Segmentation Tool and FreeSurfer.ResultsiRBD patients relative to healthy subjects exhibited a poorer performance during the nine‐hole peg test and five‐times‐sit‐to‐stand test, and greater asymmetry of arm‐swing amplitude and stride length variability during dual‐task gait. Dual task significantly worsened the walking performance of iRBD patients more than healthy controls. iRBD patients exhibited nonmotor symptoms, and memory, abstract reasoning, and visuospatial deficits. iRBD patients exhibited decreased FC of pallidum and putamen within the basal ganglia network and occipital and temporal areas within the visuo‐associative network, and a reduced volume of the supramarginal gyrus. Brain functional alterations correlated with gait changes.ConclusionsSubtle motor and nonmotor alterations were identified in iRBD patients, alongside brain structural and functional MRI changes. These findings may represent early signs of neurodegeneration and contribute to the development of predictive models for progression to parkinsonism. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Funder

Ministero della Salute

Publisher

Wiley

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