Abstract Details

Title Resting-state Functional MRI and Motion Analysis Characteristics in Patients with Isolated REM Sleep Behavior Disorder

Topic Movement Disorders

Presentation(s) P11 - Poster Session 11 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-004

Objective To assess clinical, motion analysis and resting-state functional MRI (RS-fMRI) functional connectivity (FC) alterations in iRBD patients relative to healthy subjects and the correlations between clinical features and RS-fMRI changes in iRBD.

Background Isolated REM sleep behavior disorder (iRBD) might represent an early manifestation of α-synucleinopathies. Indeed, most patients with iRBD develop neurodegenerative parkinsonism over time.

Design/Methods Thirty-eight patients with a polysomnography-confirmed iRBD and 28 age/sex-matched healthy controls underwent clinical, motion analysis, and RS-fMRI evaluations. Motion analysis was performed using a stereophotogrammetric system to assess spatio-temporal parameters during single and dual-task gait/mobility conditions. RS-fMRI images were analyzed using an Independent Component Analysis to obtain FC maps of the main RS networks.

Results IRBD patients relative to healthy controls showed a worse manual dexterity at 9-hole pegboard test (9HPT). Both iRBD patients and healthy controls worsened the spatio-temporal motion parameters during dual-task relative to single-task gait/mobility tests. However, iRBD patients showed a higher asymmetry of arm swing amplitude during 4-meter walking test (4MWT) and a higher stride length variability during 4MWT with cognitive dual-task relative to healthy subjects. Moreover, iRBD patients showed a decreased FC of pallidum within the basal ganglia network and of occipital and temporal areas within the visuo-associative network compared to healthy controls. Correlation analyses showed that the decreased FC in the basal ganglia network correlated with a worse manual dexterity and with an increased asymmetry of arm swing amplitude during 4MWT in iRBD subjects.

Conclusions This study suggested that RS-fMRI, clinical and motion analysis features could help to identify early subtle movement disorders in a subclinical phase, being promising biomarkers for early alpha-synucleinopathy detection in iRBD. Longitudinal data will allow to test a multifactorial prediction model combining fMRI, clinical and motion analysis data to predict the conversion from iRBD to parkinsonian syndromes.

Authors/Disclosures
Edoardo G. Spinelli, MD PRESENTER	Dr. Spinelli has nothing to disclose.
Elisabetta Sarasso	Elisabetta Sarasso has nothing to disclose.
Andrea Gardoni	No disclosure on file
Sara Marelli	No disclosure on file
Roberta Balestrino (Università San Raffaele)	No disclosure on file
Lucia Zenere	No disclosure on file
Silvia Basaia	Silvia Basaia has nothing to disclose.
Alessandra Castelnuovo (IRCCS San Raffaele Hospital)	No disclosure on file
Andrea Tettamanti	No disclosure on file
Luigi Ferini-Strambi, MD	Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bioprojet. Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for lundbeck. Dr. Ferini-Strambi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for idorsia. Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Italfarmaco. Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bruno Farmaceutici. Dr. Ferini-Strambi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier Sleep Medicine.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.

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