Cortical macro- and microstructural changes in isolated rapid eye movement sleep behavior disorder.

Publication date: Jul 03, 2025

Cortical mean diffusivity (cMD), a marker of cortical microstructural changes in neurodegenerative disorders, remains unexplored in isolated REM sleep behavior disorder (iRBD), a prodromal stage of Lewy body (LB) diseases. Its relationship with cortical thickness (CTh), clinical features, and neuropsychological performance is also unknown. We assessed cMD and CTh in thirty-six patients with iRBD at high risk of conversion and 29 healthy controls (HC), examining associations with clinical and cognitive measures. Effect sizes were calculated using Cohen’s d. Patients with iRBD showed increased cMD in rostral and caudal cortical regions compared to HC (d > 0. 5). Cortical thinning was restricted to caudal areas. Higher cMD correlated with longer iRBD duration, later onset, MDS-UPDRS III, apathy, and poorer performance on Grooved Pegboard and Symbol-Digit Modality Tests. These findings suggest that cMD may be more sensitive than CTh and serve as a valuable imaging biomarker for detecting early cortical changes in prodromal LB diseases.

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Concepts Keywords
Neuropsychological Behavior
Pegboard Caudal
Sleep Clinical
Stage Cmd
Thirty Cortical
Cth
Diseases
Disorder
Irbd
Isolated
Macro
Microstructural
Prodromal
Rapid
Sleep

Semantics

Type Source Name
disease MESH rapid eye movement sleep behavior disorder
disease MESH neurodegenerative disorders
disease MESH Cortical thinning
disease MESH apathy
drug DRUGBANK Angelica archangelica root
disease MESH parasomnia
disease MESH dementia
disease MESH multiple system atrophy
disease MESH Movement Disorders
drug DRUGBANK Gold
disease MESH atrophy
disease MESH cognitive decline
pathway REACTOME Neurodegenerative Diseases
disease MESH death
disease MESH demyelination
drug DRUGBANK Water
disease MESH abnormalities
disease MESH alpha synucleinopathies
disease MESH depression
disease MESH mitochondrial dysfunction
pathway REACTOME Autophagy

Original Article

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