Magnetic resonance imaging, cognition, and sex differences in Parkinson’s disease with REM sleep behavior disorder

[eng] INTRODUCTION: This doctoral thesis is centered on Parkinson’s disease (PD) with rapid eye movement sleep behavior disorder (RBD) as a clinical subtype. Characterizing subtypes is one of the main ongoing objectives of translational research on neurodegenerative diseases. Therefore, subtyping is...

Descripción completa

Detalles Bibliográficos
Autor: Oltra González, Javier
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/206860
Acceso en línea:https://hdl.handle.net/2445/206860
http://hdl.handle.net/10803/689943
Access Level:acceso abierto
Palabra clave:Malaltia de Parkinson
Trastorns del son
Ressonància magnètica
Parkinson's disease
Sleep disorders
Magnetic resonance
Descripción
Sumario:[eng] INTRODUCTION: This doctoral thesis is centered on Parkinson’s disease (PD) with rapid eye movement sleep behavior disorder (RBD) as a clinical subtype. Characterizing subtypes is one of the main ongoing objectives of translational research on neurodegenerative diseases. Therefore, subtyping is expected to play a relevant role in future precision medicine prevention, diagnosis, and treatment approaches. In this context, PD with RBD appears as a severe clinical subtype previously associated with worse clinical, cognitive, and neurodegenerative outcomes. However, the whole-brain functional connectivity of this clinical subtype has never been explored, and evidence about the brain correlates of its cognitive impairment is still scarce. The influence of sex in neurodegenerative diseases has been overlooked by previous research. Prior findings point to severe cognitive impairment and neurodegenerative profile in male PD patients. Besides, the study of the effect of sex at different stages of the disease, particularly in an early phase and on the eventual severe clinical subtypes, such as PD with RBD, could enhance the current understanding of the impact of this variable in PD. This knowledge might lead to more appropriate diagnostic strategies and specific therapeutic options in the future. HYPOTHESES: The main hypotheses of this thesis are: 1. PD-pRBD will be characterized by specific structural and functional MRI brain features associated with cognitive impairment. 2. There will be identified sex differences in cognition and structural MRI brain features in de novo PD, with worse cognitive profile and pattern of neurodegeneration in males than females. The sex differences among de novo PD patients will be more extended in the PD-pRBD group compared with the PD without probable RBD (PD- non pRBD) group. OBJECTIVES: The main objectives of this thesis are: 1. To characterize structural and functional magnetic resonance imaging (MRI) brain substrates in PD with probable RBD (PD-pRBD) and their correlates with cognitive impairment. 2. To explore sex differences in cognition and structural MRI brain features in de novo PD and de novo PD-pRBD.