基底核
医学
快速眼动睡眠
嗜睡
蓝斑
心理学
认知功能衰退
心脏病学
脑血流
神经科学
病理
多导睡眠图
听力学
基底前脑
脑电图
中枢神经系统
痴呆
疾病
作者
Simon Fristed Eskildsen,Álex Iranzo,Morten Gersel Stokholm,Kristian Stær,Karen Østergaard,Mònica Serradell,Marit Otto,Kristina Bacher Svendsen,Alícia Garrido,Dolores Vilas,Per Borghammer,Joan Santamaría,Arne Møller,Carles Gaig,David J. Brooks,Eduardo Tolosa,Leif Østergaard,Nicola Pavese
出处
期刊:Brain
[Oxford University Press]
日期:2021-04-20
卷期号:144 (5): 1498-1508
被引量:6
标识
DOI:10.1093/brain/awab054
摘要
During the prodromal period of Parkinson's disease and other α-synucleinopathy-related parkinsonisms, neurodegeneration is thought to progressively affect deep brain nuclei, such as the locus coeruleus, caudal raphe nucleus, substantia nigra, and the forebrain nucleus basalis of Meynert. Besides their involvement in the regulation of mood, sleep, behaviour, and memory functions, these nuclei also innervate parenchymal arterioles and capillaries throughout the cortex, possibly to ensure that oxygen supplies are adjusted according to the needs of neural activity. The aim of this study was to examine whether patients with isolated REM sleep behaviour disorder, a parasomnia considered to be a prodromal phenotype of α-synucleinopathies, reveal microvascular flow disturbances consistent with disrupted central blood flow control. We applied dynamic susceptibility contrast MRI to characterize the microscopic distribution of cerebral blood flow in the cortex of 20 polysomnographic-confirmed patients with isolated REM sleep behaviour disorder (17 males, age range: 54-77 years) and 25 healthy matched controls (25 males, age range: 58-76 years). Patients and controls were cognitively tested by Montreal Cognitive Assessment and Mini Mental State Examination. Results revealed profound hypoperfusion and microvascular flow disturbances throughout the cortex in patients compared to controls. In patients, the microvascular flow disturbances were seen in cortical areas associated with language comprehension, visual processing and recognition and were associated with impaired cognitive performance. We conclude that cortical blood flow abnormalities, possibly related to impaired neurogenic control, are present in patients with isolated REM sleep behaviour disorder and associated with cognitive dysfunction. We hypothesize that pharmacological restoration of perivascular neurotransmitter levels could help maintain cognitive function in patients with this prodromal phenotype of parkinsonism.
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