npj Parkinson's Disease (Oct 2024)

Progression trajectories from prodromal to overt synucleinopathies: a longitudinal, multicentric brain [18F]FDG-PET study

  • Beatrice Orso,
  • Pietro Mattioli,
  • Eun-Jin Yoon,
  • Yu Kyeong Kim,
  • Heejung Kim,
  • Jung Hwan Shin,
  • Ryul Kim,
  • Francesco Famà,
  • Andrea Brugnolo,
  • Federico Massa,
  • Agostino Chiaravalloti,
  • Mariana Fernandes,
  • Matteo Spanetta,
  • Fabio Placidi,
  • Matteo Pardini,
  • Matteo Bauckneht,
  • Silvia Morbelli,
  • Jee-Young Lee,
  • Claudio Liguori,
  • Dario Arnaldi

DOI
https://doi.org/10.1038/s41531-024-00813-z
Journal volume & issue
Vol. 10, no. 1
pp. 1 – 10

Abstract

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Abstract The phenoconversion trajectory from idiopathic/isolated Rapid eye movement (REM) sleep behavior disorder (iRBD) towards either Parkinson’s Disease (PD) or Dementia with Lewy Bodies (DLB) is currently uncertain. We investigated the capability of baseline brain [18F]FDG-PET in differentiating between iRBD patients eventually phenoconverting to PD or DLB, by deriving the denovoPDRBD-related pattern (denovoPDRBD-RP) from 32 de novo PD patients; and the denovoDLBRBD-RP from 30 de novo DLB patients, both with evidence of RBD at diagnosis. To explore [18F]FDG-PET phenoconversion trajectories prediction power, we applied these two patterns on a group of 115 iRBD patients followed longitudinally. At follow-up (25.6 ± 17.2 months), 42 iRBD patients progressed through overt alpha-synucleinopathy (21 iRBD-PD and 21 iRBD-DLB converters), while 73 patients remained stable at the last follow-up visit (43.2 ± 27.6 months). At survival analysis, both patterns were significantly associated with the phenoconversion trajectories. Brain [18F]FDG-PET is a promising biomarker to study progression trajectories in the alpha-synucleinopathy continuum.