Altered insular functional connectivity in isolated REM sleep behavior disorder: a data-driven functional MRI study

Jung-Ick Byun; Kwang Su Cha; Minah Kim; Woo-Jin Lee; Han Sang Lee; Jun-Sang Sunwoo; Jung-Won Shin; Tae-Joon Kim; Jangsup Moon; Soon-Tae Lee; Keun-Hwa Jung; Kon Chu; Man-Ho Kim; Han-Joon Kim; Won Chul Shin; Sang Kun Lee; Ki-Young Jung

doi:10.1016/j.sleep.2020.12.038

Altered insular functional connectivity in isolated REM sleep behavior disorder: a data-driven functional MRI study

Sleep Med. 2021 Mar:79:88-93. doi: 10.1016/j.sleep.2020.12.038. Epub 2021 Jan 2.

Authors

Jung-Ick Byun¹, Kwang Su Cha², Minah Kim³, Woo-Jin Lee², Han Sang Lee², Jun-Sang Sunwoo⁴, Jung-Won Shin⁵, Tae-Joon Kim⁶, Jangsup Moon⁷, Soon-Tae Lee², Keun-Hwa Jung², Kon Chu², Man-Ho Kim⁸, Han-Joon Kim², Won Chul Shin¹, Sang Kun Lee⁹, Ki-Young Jung¹⁰

Affiliations

¹ Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea.
² Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
³ Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
⁴ Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea.
⁵ Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
⁶ Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
⁷ Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Rare Disease Center, Seoul National University Hospital, Seoul, South Korea.
⁸ Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Protein Metabolism and Neuroscience Research Center, College of Medicine, Seoul National University, Seoul, South Korea.
⁹ Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: [email protected].
¹⁰ Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: [email protected].

PMID: 33485260
DOI: 10.1016/j.sleep.2020.12.038

Abstract

Objective: Functional connectivity (FC) changes can occur prior to structural changes. This study aimed to evaluate data-driven whole-brain FC associated with isolated rapid eye movement sleep behavior disorder (iRBD) using multivariate pattern analysis (MVPA).

Methods: This was a cross-sectional study of 50 polysomnography-confirmed iRBD patients and 20 age- and sex-matched controls. We used MVPA implemented in the connectome-MVPA CONN toolbox to identify data-driven seed regions for post hoc seed-to-voxel connectivity analysis. The association between FC changes and clinical characteristics, including cognition, depression, autonomic function, and daytime sleepiness, was evaluated.

Results: MVPA revealed one significant cluster located in the left posterior insular cortex. Seed-to-voxel FC analysis using the cluster as a seed showed significantly reduced FC with two clusters located in the precuneus in iRBD patients compared to the controls. The degree of FC was associated with the Montreal Cognitive Assessment-Korean version scores (r = 0.317, p = 0.025).

Conclusion: This study emphasizes the insula as an important neural correlate associated with iRBD that was associated with cognitive function.

Keywords: Cognitive function; Functional brain imaging; Multivariate pattern analysis (MVPA); Neuroimaging; REM sleep Behavior disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain
Cross-Sectional Studies
Humans
Magnetic Resonance Imaging
Polysomnography
REM Sleep Behavior Disorder* / diagnostic imaging