Correlation and underlying brain mechanisms between rapid eye movement sleep behavior disorder and executive functions in Parkinson's disease: an fNIRS study

Lu Ren; Xiaoxue Yin; Hai-Yang Wang; Xinqing Hao; Da Wang; Feng Jin; Tingting Zhang; Tao Li; Tingting Zhou; Zhanhua Liang

doi:10.3389/fnagi.2023.1290108

Correlation and underlying brain mechanisms between rapid eye movement sleep behavior disorder and executive functions in Parkinson's disease: an fNIRS study

Front Aging Neurosci. 2024 Jan 10:15:1290108. doi: 10.3389/fnagi.2023.1290108. eCollection 2023.

Authors

Lu Ren^#¹, Xiaoxue Yin^#¹, Hai-Yang Wang¹, Xinqing Hao¹, Da Wang¹, Feng Jin¹, Tingting Zhang¹, Tao Li¹, Tingting Zhou¹, Zhanhua Liang¹

Affiliation

¹ Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China.

^# Contributed equally.

Abstract

Purpose: Rapid eye movement sleep behavior disorder (RBD) affects 30%-40% of patients with Parkinson's disease (PD) and has been linked to a higher risk of cognitive impairment, especially executive dysfunction. The aim of this study was to investigate the brain activation patterns in PD patients with RBD (PD-RBD+) compared to those without RBD (PD-RBD-) and healthy controls (HCs), and to analyze the correlation between changes in cerebral cortex activity and the severity of RBD.

Methods: We recruited 50 PD patients, including 30 PD-RBD+, 20 PD-RBD-, and 20 HCs. We used functional near infrared spectroscopy during a verbal fluency task (VFT-fNIRS) and clinical neuropsychological assessment to explore the correlation between PD-RBD+ and executive function and changes in neural activity.

Results: The VFT-fNIRS analysis revealed a significant reduction in activation among PD-RBD+ patients across multiple channels when compared to both the PD-RBD- and HC groups. Specifically, PD-RBD+ patients exhibited diminished activation in the bilateral dorsolateral prefrontal cortex (DLPFC) and the right ventrolateral prefrontal cortex (VLPFC) relative to their PD-RBD- counterparts. Furthermore, compared to the HC group, PD-RBD+ patients displayed reduced activation specifically in the right DLPFC. Significantly, a noteworthy negative correlation was identified between the average change in oxygenated hemoglobin concentration (ΔHbO₂) in the right DLPFC of PD-RBD+ patients and the severity of their RBD.

Conclusion: Our study offers compelling evidence that RBD exacerbates cognitive impairment in PD, manifested as executive dysfunction, primarily attributed to reduced prefrontal activation. These aberrations in brain activation may potentially correlate with the severity of RBD.

Keywords: Parkinson’s disease; executive function; fNIRS; prefrontal cortex; rapid eye movement sleep behavior disorder.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Dalian Medical Science Research Program Project (Number: 1812009).