Brain scan Shows Potential to Predict Parkinson’s, Dementia Years Before Symptoms
Paris, โFrance – A new international study reveals a potential breakthrough in predictingโฃ the onsetโค of Parkinson’s disease โ(PD) and dementia with Lewy bodies (DLB)โค -โ sometimes years before clinical โฃsymptoms appear. Researchers have found thatโ a specialized MRI technique measuring brain waste clearance, called diffusion โtensor โimaging along the perivascular space (DTI-ALPS), can identify individuals with isolated REM sleep behavior disorder (iRBD) who are atโ higher risk of developing these neurodegenerative โฃdiseases. The findings, published in Neurology, offer a promising new avenue for earlyโฃ diagnosis and potential intervention.
iRBD, characterized by acting out dreams, โis โrecognized as โขthe strongest known predictor ofโค synucleinopathiesโ – disorders linked to the buildup of the protein alpha-synuclein, including PDโฃ and DLB. However, not everyone with iRBD will develop these conditions, making it crucial to โidentify biomarkers โthat canโ predict individual trajectories.
The study, conducted across five international centers, involved 250 patients with iRBD and 178โ healthy controls. Researchers discovered thatโ iRBD patients exhibited a โlower DTI-ALPS index in โขthe left โside of โฃthe brain compared to the control group โฃ(mean difference โข= โ0.034, 95% CI โ0.067 to โ0.001;โ p* = 0.043).
Over anโฃ average follow-up period โof 6.1 years, 65 of โthe 224 iRBD patients followed in the study converted to a synucleinopathy. Notably, those who *did convert โhad considerably lowerโค left DTI-ALPS indices โthan those who didโค not (mean difference = โ0.050, 95% CI โ0.098 to โ0.003; p* = 0.038).
The research team found that a lower left DTI-ALPS index was associated with a 2.43-fold increased risk of converting โto Parkinson’s disease โฃ(hazardโ ratio โ= โ2.43, 95% CI 1.13-5.25;โ *p = 0.012). Importantly, other โstandard MRI measurements withinโ the โperiventricular regions of theโ brain did not show similar differences between groups.
“Patients withโ iRBD โexhibit a reduced DTI-ALPS index, suggesting altered glymphatic function,” the study concludes. Theโฃ glymphatic system is โthe โbrain’sโ waste clearanceโข pathway, โand its dysfunction is thought to contributeโฃ toโข the accumulation of harmfulโฃ proteins โassociated with neurodegeneration.โข
These findings suggest that theโค DTI-ALPS โคindex could serve asโ a valuable prognostic biomarkerโข forโ identifying individuals โwith iRBD who are most likely to progress to PD or DLB, potentially allowing for earlier interventions and clinical trialsโ focused โคon slowingโ disease progression. the study underscores the growing understanding of sleep disorders as potential โฃearly warning signs for devastating neurological conditions.