ArticleMovement disorders : official journal of the Movement Disorder Society2022
Stratification Tools for Disease-Modifying Trials in Prodromal Synucleinopathy.
Article in Movement disorders : official journal of the Movement Disorder Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Article
- A Narrative Review on Biochemical Markers and Emerging Treatments in Prodromal Synucleinopathies.Clinics and practice · 2025Review
- From mechanisms to future therapy: a synopsis of isolated REM sleep behavior disorder as early synuclein-related disease.Molecular neurodegeneration · 2025Review
- Machine Learning Predicts Phenoconversion from Polysomnography in Isolated REM Sleep Behavior Disorder.Brain sciences · 2024Article
- Prodromal dementia with Lewy bodies in REM sleep behavior disorder: A multicenter study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Disease modification in Parkinsonism: obstacles and ways forward.Journal of neural transmission (Vienna, Austria : 1996) · 2022Review
- Molecular Imaging in Parkinsonian Disorders-What's New and Hot?Brain sciences · 2022Review
- Metabolic correlates of olfactory dysfunction in COVID-19 and Parkinson's disease (PD) do not overlap.European journal of nuclear medicine and molecular imaging · 2022Article
- Increased Transferrin Sialylation Predicts Phenoconversion in Isolated REM Sleep Behavior Disorder.Movement disorders : official journal of the Movement Disorder Society · 2022Article
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13 authors.
Funding
Abstract
backgroundDopamine transporter single photon-emission computed tomography (DAT-SPECT) is the strongest risk factor for phenoconversion in patients with idiopathic rapid eye movement (REM)-sleep behavior disorder (iRBD). However, it might be used as a second-line stratification tool in clinical trials, because it is expensive and mini-invasive.
objectiveAim of the study is to investigate whether other cost-effective and non-invasive biomarkers may be proposed as first-line stratification tools.
methodsForty-seven consecutive iRBD patients (68.53 ± 7.16 years, 40 males) underwent baseline clinical and neuropsychological assessment, olfaction test, resting electroencephalogram (EEG), and DAT-SPECT. All patients underwent 6 month-based clinical follow-up to investigate the emergence of parkinsonism and/or dementia. Survival analysis and Cox regression were used to estimate conversion risk.
resultsSeventeen patients developed an overt synucleinopathy (eight Parkinsonism and nine dementia) 32.8 ± 22 months after diagnosis. The strongest risk factors were putamen specific to non-displaceable binding ratio (SBR) (hazard ratio [HR], 7.3), attention/working memory cognitive function (NPS-AT/WM) (HR, 5.9), EEG occipital mean frequency (HR, 2.7) and clinical motor assessment (HR, 2.3). On multivariate Cox-regression analysis, only putamen SBR and NPS-AT/WM significantly contributed to the model (HR, 6.2, 95% confidence interval [CI], 1.9-19.8). At post-hoc analysis, the trail-making test B (TMT-B) was the single most efficient first-line stratification tool that allowed to reduce the number of eligible subjects to 76.6% (sensitivity 1, specificity 0.37). Combining TMT-B and DAT-SPECT further reduced the sample to 66% (sensitivity 0.88, specificity 0.47).
conclusionThe TMT-B seems to be a cost-effective and efficient first-line screening tool, to be used to select patients that deserve DAT-SPECT as second-line screening tool for disease-modifying clinical trials. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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