Abstract
INTRODUCTION
Isolated REM sleep behavior disorder (iRBD) is a strong prodromal marker of Lewy body diseases (LBDs) – Parkinson’s disease (PD) and dementia with Lewy bodies (DLB). Cholinergic loss is linked to cognitive decline in these conditions, but its trajectory remains unclear.
METHODS
In a cohort of 92 iRBD participants with baseline MRI, cholinergic basal forebrain (cBF) volume was measured, with longitudinal changes analyzed in 49 with follow-up scans. Cross-sectional neuropsychological associations were examined across a broader RBD–LBD continuum, including the iRBD cohort plus 65 PD and 15 DLB patients with probable RBD.
RESULTS
cBF volume declined at comparable rates in iRBD-to-PD and iRBD-to-DLB converters, but atrophy was more severe at DLB phenoconversion. cBF atrophy correlated with attention, executive, and memory deficits. In iRBD, baseline cBF z-score < −1.0 predicted dementia (hazard ratio = 9.57, p = .009).
CONCLUSION
cBF degeneration evolves from the prodromal iRBD stage of LBDs and predicts dementia, highlighting a window for cholinergic-targeted intervention.
Highlights
Basal forebrain links to attention, executive function, and memory in the RBD continuum.
Basal forebrain atrophy progresses at similar rates in prodromal PD and prodromal DLB.
At phenoconversion, basal forebrain atrophy is greater in DLB than in PD converters.
Basal forebrain atrophy strongly predicts future dementia in iRBD.
Executive dysfunction predicts faster basal forebrain degeneration in iRBD.
If you do not see content above, kindly GO TO SOURCE.
Not all publishers encode content in a way that enables republishing at Neuro.vip.
This post is Copyright: Kyung Ah Woo,
Heejung Kim,
Ryul Kim,
Bora Jin,
Jung Hwan Shin,
Seoyeon Kim,
Yu Kyeong Kim,
Hyunwoo Nam,
Beomseok Jeon,
Jee‐Young Lee | February 22, 2025