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Lookup NU author(s): Professor David BrooksORCiD, Professor Nicola PaveseORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background Reduced cortical acetylcholinesterase activity, as measured by 11C-donepezil PET, has been reported in patients with isolated REM sleep behaviour disorder (iRBD). However, its progression and clinical implications have not been fully investigated. Here, we explored the relationship between longitudinal changes in brain acetylcholinesterase activity and cognitive function in iRBD. Methods Twelve iRBD patients underwent 11C-donepezil PET at baseline and after 3 years. PET images were interrogated with Statistical Parametric Mapping (SPM) and a regions of interest (ROI) approach. Clinical progression was assessed with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III). Cognitive function was rated using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Results From baseline to follow-up, the mean 11C-donepezil distribution volume ratio (DVR) decreased in the cortex (p = 0.006), thalamus (p = 0.013) and caudate (p = 0.013) ROI. Despite no significant changes in the group mean MMSE or MoCA scores being observed, individually, seven patients showed a decline in their scores on these cognitive tests. Subgroup analysis showed that only the subgroup of patients with a decline in cognitive scores had a significant reduction in mean cortical 11C-donepezil DVR. Conclusion Our results show that severity of brain cholinergic dysfunction in iRBD patients increases significantly over 3 years, and those changes are more severe in those with a decline in cognitive test scores.
Author(s): Stær K, Iranzo A, Terkelsen MH, Stokholm MGS, Danielsen EH, Østergaard K, Serradell M, Otto M, Svendsen KB, Garrido A, Vilas D, Santamaria J, Møller A, Gaig C, Brooks DJ, Borghammer P, Tolosa E, Pavese N
Publication type: Article
Publication status: Published
Journal: European Journal of Neurology
Year: 2024
Volume: 31
Issue: 1
Print publication date: 01/01/2024
Online publication date: 17/10/2023
Acceptance date: 27/09/2023
Date deposited: 29/09/2023
ISSN (print): 1351-5101
ISSN (electronic): 1468-1331
Publisher: Wiley
URL: https://doi.org/10.1111/ene.16101
DOI: 10.1111/ene.16101
ePrints DOI: 10.57711/dhhj-wg83
Data Access Statement: Our data primarily consist of PET images that cannot be completely anonymized and are therefore not suitable for open sharing.
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