Higher glymphatic system activity is linked to longer prodromal stage in isolated REM sleep behavior disorder: a possible protective factor.
Higher glymphatic system activity is linked to longer prodromal stage in isolated REM sleep behavior disorder: a possible protective factor.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Prague, CZ · Author affiliation
Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic. veronika.rottova@vfn.cz.Location evidence
Kladno, CZ · Author affiliation
Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic.Location evidence
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Original abstract
Isolated rapid eye movement sleep behavior disorder (iRBD) is recognized as a prodromal stage of alpha-synucleinopathies. While glymphatic dysfunction has been investigated in Parkinson's disease, its role in iRBD remains incompletely understood. This study evaluated the association between glymphatic function and the speed-modulating effect to alpha-synucleionpathy conversion. Fifty-six patients (67.2 ± 7.1 [mean age ± SD]) with an iRBD and 48 control subjects (61.5 ± 10.0) underwent brain magnetic resonance imaging. Glymphatic function was evaluated using the diffusion tensor imaging along the perivascular space (DTI-ALPS) method with manual acquisition of the ALPS-index. The mean time from symptom onset to MRI acquisition (T1) was 7.05 ± 5.08 years, while among converters the mean time from symptom onset to phenoconversion (T2) was 11.07 ± 5.68 years. Higher ALPS-index was positively correlated with longer iRBD symptom duration (rho = 0.409, p = 0.002). Although the ALPS-index did not predict phenoconversion in the entire cohort, post-hoc analysis of converters revealed that patients with higher ALPS-index exhibited more than nine years longer time to conversion than patients with lower ALPS-index (χ² = 13.075, p < 0.001). These findings suggest that preserved glymphatic function may be associated with prolonged prodromal stability in iRBD.