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Campabadal A, Abos A, Segura B, Serradell M, Uribe C, Baggio HC, Gaig C, Santamaria J, Compta Y, Bargallo N, Junque C, Iranzo A. Disruption of posterior brain functional connectivity and its relation to cognitive impairment in idiopathic REM sleep behavior disorder. Neuroimage Clin 2019; 25:102138. [PMID: 31911344 PMCID: PMC6948254 DOI: 10.1016/j.nicl.2019.102138] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/12/2022]
Abstract
There is a reduced brain posterior functional connectivity in IRBD patients. Reduced temporo-parietal connectivity correlates with mental processing slowness. Left superior parietal lobule has reduced centrality in IRBD patients.
Background Resting-state functional MRI has been proposed as a new biomarker of prodromal neurodegenerative disorders, but it has been poorly investigated in the idiopathic form of rapid-eye-movement sleep behavior disorder (IRBD), a clinical harbinger of subsequent synucleinopathy. Particularly, a complex-network approach has not been tested to study brain functional connectivity in IRBD patients. Objectives The aim of the current work is to characterize resting-state functional connectivity in IRBD patients using a complex-network approach and to determine its possible relation to cognitive impairment. Method Twenty patients with IRBD and 27 matched healthy controls (HC) underwent resting-state functional MRI with a 3T scanner and a comprehensive neuropsychological battery. The functional connectome was studied using threshold-free network-based statistics. Global and local network parameters were calculated based on graph theory and compared between groups. Head motion, age and sex were introduced as covariates in all analyses. Results IRBD patients showed reduced cortico-cortical functional connectivity strength in comparison with HC in edges located in posterior regions (p <0.05, FWE corrected). This regional pattern was also shown in an independent analysis comprising posterior areas where a decreased connectivity in 51 edges was found, whereas no significant results were detected when an anterior network was considered (p <0.05, FWE corrected). In the posterior network, the left superior parietal lobule had reduced centrality in IRBD. Functional connectivity strength between left inferior temporal lobe and right superior parietal lobule positively correlated with mental processing speed in IRBD (r = .633; p = .003). No significant correlations were found in the HC group. Conclusion : Our findings support the presence of disrupted posterior functional brain connectivity of IRBD patients similar to that found in synucleinopathies. Moreover, connectivity reductions in IRBD were associated with lower performance in mental processing speed domain.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain
| | - M Serradell
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - C Gaig
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - J Santamaria
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Y Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Parkinson's disease & Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain..
| | - A Iranzo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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Campabadal A, Segura B, Junque C, Serradell M, Abos A, Uribe C, Baggio HC, Gaig C, Santamaria J, Bargallo N, Iranzo A. Comparing the accuracy and neuroanatomical correlates of the UPSIT-40 and the Sniffin' Sticks test in REM sleep behavior disorder. Parkinsonism Relat Disord 2019; 65:197-202. [PMID: 31253493 DOI: 10.1016/j.parkreldis.2019.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 05/30/2019] [Accepted: 06/19/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Olfactory impairment increases the risk of developing neurodegenerative diseases in patients with idiopathic REM sleep behavior disorder (IRBD). Knowing the test properties of distinct olfactory measures could contribute to their selection for clinical or research purposes. OBJECTIVE To compare the accuracy in distinguishing IRBD patients from controls with the University of Pennsylvania Smell Identification Test (UPSIT-40) and Sniffin' Sticks Extended test, and to assess the gray-matter volume correlates of these tests. METHOD Twenty-one patients with IRBD and 27 healthy controls were assessed using both olfactory tests. Independent logistic regressions were computed with diagnosis as a dependent variable and olfactory measures as predictive variables. Receiver operating characteristic curves were computed for each olfactory subtest. Diagnostic accuracy for IRBD was calculated according to the resulting optimal cut-off score. Structural MRI data, acquired with a 3T scanner, were analyzed with voxel-based morphometry. RESULTS Patients differed from controls in all olfactory measures. The Sniffin-Identification correctly classified 89.1% of cases; the UPSIT-40, 85.4%; the Sniffin-Discrimination, 82.6%; the Sniffin-Total, 81.8%; and the Sniffin-Threshold, 77.3%. Respective AUROC, optimal cut-off, sensitivity, and specificity for each test were: 0.902, ≤26, 85.7%, and 85.2% for the UPSIT-40; 0.884, ≤29, 89.5%, and 76.0% for the Sniffin-Total; 0.922, ≤11, 90.5%, and 88.0% for the Sniffin-Identification; 0.739, ≤4, 73.7%, and 76.0% for the Sniffin-Threshold; and 0.838, ≤11, 85.7%, and 76.0% for the Sniffin-Discrimination. UPSIT-40 scores correlated with gray-matter volumes in orbitofrontal regions in anosmic patients. CONCLUSIONS UPSIT-40 and Sniffin' Identification showed similar discrimination accuracy, but only the UPSIT-40 showed structural correlates (p ≤ .05 FDR-corrected).
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - B Segura
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.
| | - C Junque
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
| | - M Serradell
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - A Abos
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - C Uribe
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - C Gaig
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - J Santamaria
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain.
| | - A Iranzo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
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Campabadal A, Segura B, Baggio HC, Abos A, Uribe C, Garcia-Diaz AI, Marti MJ, Valldeoriola F, Compta Y, Bargallo N, Junque C. Diagnostic Accuracy, Item Analysis and Age Effects of the UPSIT Spanish Version in Parkinson's Disease. Arch Clin Neuropsychol 2019; 34:435-444. [PMID: 30007334 DOI: 10.1093/arclin/acy053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE The University of Pennsylvania Smell Identification Test (UPSIT) is the most commonly used test to detect olfactory impairment in Parkinson's disease (PD), but the cut-off score for clinical purposes is often difficult to establish because of age and sex effects. The current work aims to study the sensitivity and specificity of the UPSIT Spanish version and its accuracy in discriminating PD patients at different age groups from healthy controls (HC), and to perform an item analysis. METHOD Ninety-seven non-demented PD patients and 65 HC were assessed with the UPSIT Spanish version. Sensitivity, specificity, and diagnostic accuracy for PD were calculated. Multiple regression analysis was used to define predictors of UPSIT scores. RESULTS Using the normative cut-off score for anosmia (≤18), the UPSIT showed a sensitivity of 54.6% with a specificity of 100.0% for PD. We found that, using the UPSIT cut-off score of ≤25, sensitivity was 81.4% and specificity 84.6% (area under the receiver operating characteristic curve = 0.908). Diagnosis and age were good predictors of UPSIT scores (B = -10.948; p < .001; B = -0.203; p < .001). When optimal cut-off scores were considered according to age ranges (≤60, 61-70, and ≥71), sensitivity and specificity values were >80.0% for all age groups. CONCLUSIONS In the Spanish UPSIT version, sensitivity and specificity are improved when specific cut-off scores for different age groups are computed.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - A I Garcia-Diaz
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - M J Marti
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.,Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - F Valldeoriola
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.,Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - Y Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.,Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
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