Abstract Details

Title Parkinson's Disease Metabolic Network Predicts Phenoconversion in Patients with Idiopathic REM Sleep Behavior Disorder

Topic Sleep

Presentation(s) S19 - (-)

Poster/Presentation
Number 004

Objective

Background Synucleinopathies such as PD and Dementia with Lewy Bodies (DLB) develop in over 50% of iRBD patients. However, biomarkers to predict the likelihood of phenoconversion to neurodegenerative disease in these individuals are limited.

Design/Methods Eighteen patients (age 67.7 ± 7.0 years) with iRBD underwent 99mTc-ECD SPECT, and were followed clinically for an average of three years. During this period, eight subjects phenoconverted, developing symptoms of PD (n=5) or DLB (n=3). The remaining 10 subjects did not phenoconvert after an average follow-up period of five years. Blinded investigators computed PDRP expression in the iRBD scans, which were compared to control values from 18 age-matched healthy subjects. Logistic regression was used to determine whether the PDRP values correlated with ultimate phenoconversion status.

Results PDRP expression was abnormally elevated in the iRBD patients (p<0.003), a finding replicated in FDG-PET scans from an independent cohort of nine iRBD and nine control subjects. In both iRBD groups, PDRP expression was elevated to levels similar to those previously reported from the ipsilateral ("preclinical") hemispheres of hemi-PD patients. In the 18 iRBD subjects with follow-up, the degree of PDRP expression correlated with the eventual development of defined neurodegenerative disease (R2= 0.28, p=0.01). Phenoconversion status also independently correlated with age at imaging (R2=0.27, p<0.02). Together, PDRP expression and age accounted for 64.4% of the variation in final phenoconversion status (p<0.0001).

Conclusions PDRP expression is reproducibly increased in iRBD at a level consistent with "prodromal" disease. The data suggest that pattern expression and age are independent and additive predictors of ultimate phenoconversion in patients with iRBD.

Authors/Disclosures
Florian Holtbernd, MD (The Feinstein Institute for Medical Research) PRESENTER	No disclosure on file
Jean-Francois Gagnon (Centre D'etude Du Sommeil)	The institution of Jean-Francois Gagnon has received research support from Canadian Institute of Health Research. The institution of Jean-Francois Gagnon has received research support from Canada Research Chair. The institution of Jean-Francois Gagnon has received research support from National Institutes of Health.
	No disclosure on file
Ronald Postuma, MD (Montreal General Hospital)	Dr. Postuma has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche, Biogen, Takeda, Theranexus, GE, Jazz, Curasen, Paladin, Inception Sciences, Phytopharmics, Vaxxinity, Merck. Dr. Postuma has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen/Partners. The institution of Dr. Postuma has received research support from CIHR, Weston Foundation, Webster Foundation, Roche, MJFF, Parkinson Canada, FRSQ, NIH.
Yilong Ma, PhD (Feinstein Institute for Medical Research)	The institution of Dr. Ma has received research support from AskBio. The institution of Dr. Ma has received research support from Aspen Neuroscience . The institution of Dr. Ma has received research support from Blue Rock . The institution of Dr. Ma has received research support from Bayer.
	No disclosure on file
	No disclosure on file
David Eidelberg, MD, FAAN (Feinstein Institute for Medical Research)	Dr. Eidelberg has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for MeiraGTx. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TreeFrog Therapeutics. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Blue Rock Therapeutics, Inc.. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SANA Biotechnology, Inc. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bio Vie, Inc.. Dr. Eidelberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for KenaiTx, Inc.. Dr. Eidelberg has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aspen Neuroscience. Dr. Eidelberg has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Oxford University Press. The institution of Dr. Eidelberg has received research support from The Michael J. Fox Foundation for Parkinson's Research. The institution of Dr. Eidelberg has received research support from Lupus Research Alliance. The institution of Dr. Eidelberg has received research support from National Institutes of Health. The institution of Dr. Eidelberg has received research support from Blue Rock Therapeutics. The institution of Dr. Eidelberg has received research support from National Institute of Neurological Disorders and Stroke. The institution of Dr. Eidelberg has received research support from The Michael J. Fox Foundation for Parkinson's Research. The institution of Dr. Eidelberg has received research support from National Institute of Allergy and Infectious Diseases. The institution of Dr. Eidelberg has received research support from Aspen Neurosciences, Inc. . The institution of Dr. Eidelberg has received research support from NIH. Dr. Eidelberg has received intellectual property interests from a discovery or technology relating to health care. Dr. Eidelberg has received intellectual property interests from a discovery or technology relating to health care.
Nazem Atassi, MD	Dr. Atassi has received personal compensation for serving as an employee of Sanofi. Dr. Atassi has stock in Sanofi.
Jacques Montplaisir, MD, PhD	The institution of Dr. Montplaisir has received research support from CIHR.
	No disclosure on file

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