Patients with REM sleep behavior disorder may be identified as high-risk for developing Parkinson's disease using MRI technology without radiation exposure, according to a study from Samsung Medical Center.
The research team, including neurologist Joo Eun-yeon and radiologists Kim Eung-yeob and Son Beom-seok from Samsung Medical Center, along with Professor Kim Jae-rim from Sejong Chungnam National University Hospital, announced on August 10 that they confirmed the ability to screen high-risk Parkinson's patients using 'neuromelanin-sensitive MRI (NM-MRI).' The findings were published in the latest issue of the international journal Brain Imaging and Behavior.
Parkinson's disease is a chronic neurodegenerative disorder characterized by the gradual loss of dopamine neurons in the midbrain. It presents with motor symptoms such as tremors, muscle rigidity, and gait disturbances, as well as non-motor symptoms including reduced sense of smell, sleep disorders, autonomic nervous system abnormalities, and cognitive decline.
REM sleep behavior disorder involves acting out dreams during sleep, such as shouting or moving limbs. While it is often detected in the early stages before the onset of Parkinson's disease, not all patients will progress to Parkinson's, making early identification of high-risk patients crucial.
Currently, the primary test for assessing the risk of Parkinson's disease is the dopamine transporter (DaT) PET scan. However, this test is costly, limited to certain facilities, and requires the use of radioactive isotopes, making it impractical for all patients.
To address these limitations, the research team utilized neuromelanin-sensitive MRI. Neuromelanin is a pigment found in dopamine neurons, and its levels decrease when these neurons are damaged. By analyzing the volume and signal intensity of neuromelanin in MRI scans, the extent of dopamine neuron damage can be indirectly assessed.
The team conducted neuromelanin-sensitive MRI on 66 patients with REM sleep behavior disorder and 30 healthy controls, comparing the results with dopamine PET scan findings. They categorized the patients into two groups: 37 with abnormal findings on the PET scan and 29 with normal results.
The analysis revealed a significant reduction in neuromelanin volume and signal intensity in the group with abnormal PET scan results, while no significant differences were observed between the normal PET group and healthy controls.
The research team clarified that this study does not imply that neuromelanin-sensitive MRI can replace dopamine PET scans. Instead, it suggests a potential patient-centered testing strategy where high-risk patients are first screened with MRI, followed by PET scans only when necessary.
Professor Son Beom-seok, the first author, stated, "Neuromelanin-sensitive MRI can be performed repeatedly without concerns about radiation exposure and can be conducted alongside standard brain MRI, which is a significant advantage."
* This article has been translated by AI.
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