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Assessing whole brain perfusion changes in patients with REM sleep behavior disorder

From Centre d'Étude du Sommeil et des Rythmes Biologiques (S.M., M.M., R.P., J.M.-M., A.D., J.M.), Hôpital du Sacré-Cur de Montréal; Department of Nuclear Medicine (J.P.S.), Centre Hospitalier de l'Université de Montréal; Department of Neurology and Neurosurgery (P.G.), McGill University, Montréal; and Department of Neurology (R.P.), Montreal General Hospital, Montreal, Quebec, Canada.

Address correspondence and reprint requests to Dr. Jacques Montplaisir, Centre d'Étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Cur de Montréal, 5400 Boul. Gouin Ouest, Montréal, Québec, Canada, H4J 1C5; e-mail: JY.Montplaisir{at}UMontreal.CA

Objective: To investigate the regional cerebral perfusion in patients with idiopathic REM behavior disorder (RBD) in order to establish the topography of networks involved.

Methods: We performed cerebral blood flow evaluation using ^99mTc-Ethylene Cysteinate Dimer (ECD) SPECT on eight patients with polysomnographically confirmed RBD and nine age-matched controls. Comparisons were made using SPM2.

Results: We found increased perfusion in the pons and putamen bilaterally and in the right hippocampus. In addition, we observed a decreased perfusion in frontal (Brodmann area [BA] 4, 6, 10, 43, 44, 47 bilaterally and left BA 9, 46) and temporo-parietal (BA 13, 22, 43 bilaterally and left BA 7, 19, 20, 21, 39, 40, 41, 42) cortices.

Conclusion: Perfusional abnormalities in patients with REM behavior disorder were located in the brainstem, striatum, and cortex. These abnormalities are consistent with the anatomic metabolic profile of Parkinson disease.

Supported by the Canadian Institute of Health Research and The Canadian Senior Chair on Sleep Disorders.

Disclosure: The authors report no conflicts of interest.

Received January 12, 2006. Accepted in final form July 5, 2006.

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