BackgroundRapid eye movement sleep behavior disorder (RBD) is linked to the diffuse‐malignant subtype and higher cognitive burden in Lewy body disease (LBD).ObjectiveThis study explores brain β‐amyloid deposition and its association with cognitive decline across the RBD–LBD continuum.MethodsPatients with isolated RBD (iRBD), Parkinson's disease with probable RBD (PDRBD), and dementia with Lewy bodies with probable RBD (DLBRBD) underwent 18F‐florbetaben positron emission tomography, 3T magnetic resonance imaging scans, and comprehensive neuropsychological assessments. Subjects were categorized as cognitively normal (NC), mild cognitive impairment (MCI), or dementia. Global and regional standardized uptake value ratios (SUVR) were estimated in predefined cognitive volumes of interest (VOI) derived from voxel‐wise comparison analysis among the cognitive groups, namely the prefrontal, parietal, precentral cortices, lingual gyrus, and supplementary motor area. Generalized linear models assessed the relationship between 18F‐florbetaben SUVRs and neuropsychological testing, adjusting for age and sex. Subgroup analysis focused on the polysomnography‐confirmed iRBD‐continuum subset (n = 41) encompassing phenoconverters and nonconverters in our prospective iRBD cohort.ResultsEighty‐six subjects were classified as follows: 14 NC, 54 MCI, and 18 dementia. The proportion of positive β‐amyloid scans increased with advanced cognitive stages (P = 0.038). β‐Amyloid signals in cognitive VOIs were elevated in subgroups showing impairment in Trail‐Making Test B (TMT‐B). A linear association between TMT‐B z score and global cortical β‐amyloid levels was observed in the iRBD‐continuum subset (P = 0.013).ConclusionCortical β‐amyloid accumulates with declines in executive function within the RBD–LBD continuum. TMT‐B performance may be a useful marker associating with β‐amyloid load, particularly in the iRBD population. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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β-淀粉样蛋白负荷对快速眼动睡眠行为障碍 - 路易体病连续体的认知影响


背景快速眼动睡眠行为障碍 （RBD） 与路易体病 （LBD） 的弥漫性恶性亚型和较高的认知负担有关。目的本研究探讨了脑 β-淀粉样蛋白沉积及其与 RBD-LBD 连续体认知能力下降的关系。方法对孤立性 RBD （iRBD）、疑似 RBD 的帕金森病 （PDRBD） 和疑似 RBD 的路易体痴呆 （DLBRBD） 患者行 18F-florbetaben 正电子发射断层扫描、3T 磁共振成像扫描和综合神经心理学评估。受试者被归类为认知正常 （NC）、轻度认知障碍 （MCI） 或痴呆。全球和区域标准化摄取值比 （SUVR） 以预定义的感兴趣认知体积 （VOI） 估计，该兴趣体积 （VOI） 来自认知组之间的体素比较分析，即前额叶、顶叶、中央前皮层、舌回和辅助运动区。广义线性模型评估了 18F-florbetaben SUVR 与神经心理学测试之间的关系，并调整了年龄和性别。亚组分析侧重于多导睡眠图证实的 iRBD 连续体子集 （n = 41），包括我们前瞻性 iRBD 队列中的表型转化者和非转化者。结果86 名受试者分类如下：14 名 NC，54 名 MCI 和 18 名痴呆。β-淀粉样蛋白扫描阳性的比例随着认知阶段的增加而增加 （P = 0.038）。认知 VOI 中的 β-淀粉样蛋白信号在 Trail-Making Test B （TMT-B） 中显示损伤的亚组中升高。在 iRBD 连续体子集中观察到 TMT-B z 评分与整体皮质 β-淀粉样蛋白水平之间的线性关联 （P = 0.013）。结论皮质 β-淀粉样蛋白在 RBD-LBD 连续体中随着执行功能的下降而积累。TMT-B 性能可能是与 β-淀粉样蛋白载量相关的有用标志物，尤其是在 iRBD 人群中。© 2024 作者。由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版的《运动障碍》。