Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder
Abstract Idiopathic REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies including Parkinson’s disease (PD), yet its clinical heterogeneity remains underexplored. This study aimed to identify novel brain-clinical biotypes in iRBD by integrating structural MRI and clinical a...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-06-01
|
| Series: | npj Parkinson's Disease |
| Online Access: | https://doi.org/10.1038/s41531-025-01012-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850136699825291264 |
|---|---|
| author | Shi Tang Bei Huang Yanlin Wang Yaping Liu Jing Wang Li Zhou Siyi Gong Yuhua Yang Joey WY Chan Steven WH Chau Winnie CW Chu Jill Abrigo Jean-François Gagnon Yun Kwok Wing |
| author_facet | Shi Tang Bei Huang Yanlin Wang Yaping Liu Jing Wang Li Zhou Siyi Gong Yuhua Yang Joey WY Chan Steven WH Chau Winnie CW Chu Jill Abrigo Jean-François Gagnon Yun Kwok Wing |
| author_sort | Shi Tang |
| collection | DOAJ |
| description | Abstract Idiopathic REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies including Parkinson’s disease (PD), yet its clinical heterogeneity remains underexplored. This study aimed to identify novel brain-clinical biotypes in iRBD by integrating structural MRI and clinical assessments. We included 172 patients with video-polysomnography-confirmed iRBD and 126 controls who underwent multimodal MRI and clinical evaluation. Similarity Network Fusion was used to integrate cortical thickness, surface area, subcortical volume, and clinical data, followed by spectral clustering to identify iRBD biotypes. Two distinct biotypes were identified: Biotype 1 showed widespread cortical-subcortical-cerebellar atrophy, functional hypoconnectivity, more motor and cognitive deficits with higher prodromal PD risk; Biotype 2 demonstrated increased surface area in limbic and parietal regions, cortical-cerebellar hyperconnectivity, and preserved neurocognitive function. These findings underscore the presence of distinct neurobiological subtypes in iRBD, highlighting the need for longitudinal monitoring to clarify their trajectories and implications for disease progression. |
| format | Article |
| id | doaj-art-0f23ca114d9643b0b1e4eeb1374e2f12 |
| institution | OA Journals |
| issn | 2373-8057 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Parkinson's Disease |
| spelling | doaj-art-0f23ca114d9643b0b1e4eeb1374e2f122025-08-20T02:31:03ZengNature Portfolionpj Parkinson's Disease2373-80572025-06-0111111010.1038/s41531-025-01012-0Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorderShi Tang0Bei Huang1Yanlin Wang2Yaping Liu3Jing Wang4Li Zhou5Siyi Gong6Yuhua Yang7Joey WY Chan8Steven WH Chau9Winnie CW Chu10Jill Abrigo11Jean-François Gagnon12Yun Kwok Wing13Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongBrain and Mind Institute, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongDepartment of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong KongDepartment of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong KongCenter for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de MontréalDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong KongAbstract Idiopathic REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies including Parkinson’s disease (PD), yet its clinical heterogeneity remains underexplored. This study aimed to identify novel brain-clinical biotypes in iRBD by integrating structural MRI and clinical assessments. We included 172 patients with video-polysomnography-confirmed iRBD and 126 controls who underwent multimodal MRI and clinical evaluation. Similarity Network Fusion was used to integrate cortical thickness, surface area, subcortical volume, and clinical data, followed by spectral clustering to identify iRBD biotypes. Two distinct biotypes were identified: Biotype 1 showed widespread cortical-subcortical-cerebellar atrophy, functional hypoconnectivity, more motor and cognitive deficits with higher prodromal PD risk; Biotype 2 demonstrated increased surface area in limbic and parietal regions, cortical-cerebellar hyperconnectivity, and preserved neurocognitive function. These findings underscore the presence of distinct neurobiological subtypes in iRBD, highlighting the need for longitudinal monitoring to clarify their trajectories and implications for disease progression.https://doi.org/10.1038/s41531-025-01012-0 |
| spellingShingle | Shi Tang Bei Huang Yanlin Wang Yaping Liu Jing Wang Li Zhou Siyi Gong Yuhua Yang Joey WY Chan Steven WH Chau Winnie CW Chu Jill Abrigo Jean-François Gagnon Yun Kwok Wing Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder npj Parkinson's Disease |
| title | Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder |
| title_full | Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder |
| title_fullStr | Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder |
| title_full_unstemmed | Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder |
| title_short | Brain-clinical biotyping in patients with idiopathic REM sleep behavior disorder |
| title_sort | brain clinical biotyping in patients with idiopathic rem sleep behavior disorder |
| url | https://doi.org/10.1038/s41531-025-01012-0 |
| work_keys_str_mv | AT shitang brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT beihuang brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT yanlinwang brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT yapingliu brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT jingwang brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT lizhou brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT siyigong brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT yuhuayang brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT joeywychan brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT stevenwhchau brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT winniecwchu brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT jillabrigo brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT jeanfrancoisgagnon brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder AT yunkwokwing brainclinicalbiotypinginpatientswithidiopathicremsleepbehaviordisorder |