In-vivo staging of pathology in REM sleep behaviour disorder: a multimodality imaging case-control study

摘要

Background Accumulating evidence suggests that a-synuclein aggregates-a defining pathology of Parkinson's disease-display cell-to-cell transmission. a-synuclein aggregation is hypothesised to start in autonomic nerve terminals years before the appearance of motor symptoms, and subsequently spread via autonomic nerves to the spinal cord and brainstem. To assess this hypothesis, we investigated sympathetic, parasympathetic, noradrenergic, and dopaminergic innervation in patients with idiopathic rapid eye movement (REM) sleep behaviour disorder, a prodromal phenotype of Parkinson's disease.