Dorsolateral nigral hyperintensity in idiopathic REM sleep behavior disorder: a systematic review and meta-analysis.
Dorsolateral nigral hyperintensity in idiopathic REM sleep behavior disorder: a systematic review and meta-analysis.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
London, GB · Author affiliation
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Department of Neurology, Agios Pavlos General Hospital of Thessaloniki, Leoforos Ethnikis Antistaseos 161, Thessaloniki, 55134, Greece; Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University Campus, Thessaloniki, 54124, Greece. Electronic address: vasilis-spyridon.tseriotis.24@ucl.ac.uk.Location evidence
Thessaloníki, GR · Author affiliation
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Department of Neurology, Agios Pavlos General Hospital of Thessaloniki, Leoforos Ethnikis Antistaseos 161, Thessaloniki, 55134, Greece; Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University Campus, Thessaloniki, 54124, Greece. Electronic address: vasilis-spyridon.tseriotis.24@ucl.ac.uk.Location evidence
Lisbon, PT · Author affiliation
Department of Neurology, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal; Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal. Electronic address: fvs.carvalho@gmail.com.Location evidence
Grenoble, FR · Author affiliation
Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble Institute of Neuroscience, INSERM, U1216, Grenoble, France. Electronic address: emoro@chu-grenoble.fr.Location evidence
Bern, CH · Author affiliation
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland. Electronic address: claudio.bassetti@unibe.ch.Location evidence
Berlin, DE · Author affiliation
Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: mike.wattjes@charite.de.Location evidence
Tallaght, IE · Author affiliation
Department of Neurology, Tallaght University Hospital (TUH) / the Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital (AMNCH), Dublin, Ireland; 1st Department of Neurology, Eginition Hospital, Medical School, National & Kapodistrian University of Athens, Greece. Electronic address: mavridismdr@gmail.com.Location evidence
Dublin, IE · Author affiliation
Department of Neurology, Tallaght University Hospital (TUH) / the Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital (AMNCH), Dublin, Ireland; 1st Department of Neurology, Eginition Hospital, Medical School, National & Kapodistrian University of Athens, Greece. Electronic address: mavridismdr@gmail.com.Location evidence
Athens, GR · Author affiliation
Department of Neurology, Tallaght University Hospital (TUH) / the Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital (AMNCH), Dublin, Ireland; 1st Department of Neurology, Eginition Hospital, Medical School, National & Kapodistrian University of Athens, Greece. Electronic address: mavridismdr@gmail.com.Location evidence
Barcelona, ES · Author affiliation
Neurology-Neuroimmunology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall D'Hebron Barcelona Hospital Campus, Barcelona, Spain. Electronic address: ctur@cem-cat.org.Location evidence
Buenos Aires, AR · Author affiliation
Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina; CENRos, Neuroimmunology Clinic, INECO Neurociencias Oroño, Rosario, Argentina. Electronic address: junior.carnero@hotmail.com.Location evidence
Rosario, AR · Author affiliation
Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina; CENRos, Neuroimmunology Clinic, INECO Neurociencias Oroño, Rosario, Argentina. Electronic address: junior.carnero@hotmail.com.Location evidence
Belgrade, RS · Author affiliation
Faculty of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: aca.smed01@gmail.com.Location evidence
Ioánnina, GR · Author affiliation
Department of Neurology, General Hospital of Ioannina, Ioannina, Greece. Electronic address: gkiraich@outlook.com.Location evidence
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Original abstract
Dorsolateral nigral hyperintensity (DNH) on iron-sensitive MRI is a candidate biomarker of nigrostriatal degeneration. We systematically reviewed evidence on the diagnostic utility of visual DNH assessment in idiopathic REM sleep behavior disorder (iRBD), including concordance with 123I-FP-CIT SPECT and disease stage. MEDLINE, Scopus, Web of Science, ProQuest, and Google Scholar were searched for observational studies assessing DNH in iRBD. Study quality was evaluated using QUADAS-2. Random-effects meta-analyses were performed for diagnostic accuracy and odds ratios (OR), with meta-regression used to explore heterogeneity. Six eligible studies investigated DNH abnormalities in 148 iRBD subjects, 237 PD subjects and 188 healthy controls (HCs), using 3-7T susceptibility-based MRI. Pooled sensitivity and specificity for iRBD-HCs differentiation were 0.54 [0.39; 0.69] (I2 = 72.1%) and 0.89 [0.81; 0.94] (I2 = 0.0%), respectively, with heterogeneity explained by motor severity in iRBD individuals. DNH abnormalities showed good performance in identifying iRBD individuals with abnormal 123I-FP-CIT SPECT (sensitivity = 0.73 [0.55; 0.86], I2 = 30.9%; specificity = 0.77 [0.54; 0.91], I2 = 57.2%). PD individuals were significantly more likely to exhibit DNH abnormalities compared to iRBD (pooled OR = 13.06 [1.97-86.55], p = 0.0196); I2 = 63.8%). Visual DNH assessment is a specific, non-invasive marker of prodromal alpha-synucleinopathy, but methodological heterogeneity and imprecision warrant standardized imaging and longitudinal validation.