@article{a37ece2d93524e51a2dc9e3b161714d6,
title = "Neuroimaging-evident lesional pathology associated with REM sleep behavior disorder",
abstract = "Background/Rationale: Rapid eye movement (REM) sleep behavior disorder (RBD) is a potentially injurious parasomnia characterized by dream enactment behavior and polysomnographic REM sleep without atonia (RSWA). Recently, RBD not only has been shown to be strongly associated with synucleinopathy neurodegeneration but has also been rarely reported to be associated with structural lesions involving the brainstem or limbic system. The aim of this study was to describe the clinical, neuroimaging, and outcome characteristics in a case series of patients with lesional RBD. Methods: This is a retrospective case series from a tertiary care referral center. Results: A total of 10 patients with lesional RBD were identified. Seven (70%) were men, with an average age of sleep symptom onset of 53.7 ± 17.0 years. Structural pathology evident on neuroimaging included four extraaxial (three meningiomas and one basilar fusiform aneurysm with brainstem compression) and six intraaxial (encephalomalacia, multiple sclerosis, vasculitis, autoimmune limbic encephalitis, and leukodystrophy) lesions. No patient developed parkinsonian features or cognitive impairment suggestive of synucleinopathy over an average of 45.4 ± 35.2 months of follow-up. Conclusions: RBD is rarely associated with non-synuclein structural lesions affecting the pons, medulla, or limbic system. The spectrum of lesional RBD comprises tumors, aneurysms, leukodystrophy, and autoimmune/inflammatory/demyelinating brain lesions.",
keywords = "Brain lesion, Neuroimaging, Outcome, Parasomnia, REM sleep behavior disorder",
author = "McCarter, {Stuart J.} and Maja Tippmann-Peikert and Sandness, {David J.} and Flanagan, {Eoin P.} and Kejal Kantarci and Boeve, {Bradley F.} and Silber, {Michael H.} and {St. Louis}, {Erik K.}",
note = "Funding Information: K Kantarci serves on the data safety monitoring board for Pfizer Inc. and Jannsen Alzheimer's Immunothrapy, Takeda Global Research & Development Center, Inc.; she is funded by the NIH [R01AG040042 (PI), P50 AG44170/Project 2 (PI) and R01 AG11378 (Co-I). Funding Information: This project was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant Number 1 UL1 RR024150-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding Information: BF Boeve has served as an investigator for a clinical trial sponsored by GE Healthcare. He receives royalties from the publication of a book entitled Behavioral Neurology of Dementia (Cambridge Medicine, 2009). He serves on the scientific advisory board of the Tau Consortium. He receives research support from the NIH (U01 AG045390, U54 NS092089, P50 AG016574, UO1 AG006786, RO1 AG015866, RO1 AG032306, RO1 AG041797) and the Mangurian Foundation. Funding Information: EK St. Louis reports that he received research support from the Mayo Clinic Center for Translational Science Activities (CTSA), supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through Grant Number 1 UL1 RR024150-01. Publisher Copyright: {\textcopyright} 2015 Elsevier B.V.",
year = "2015",
month = dec,
doi = "10.1016/j.sleep.2015.07.018",
language = "English (US)",
volume = "16",
pages = "1502--1510",
journal = "Sleep Medicine",
issn = "1389-9457",
publisher = "Elsevier",
number = "12",
}