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

• DOI: 10.1016/j.sleep.2020.12.038
• Publication Date: 2021-01-02T06:43:04Z
• Authors: 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
• Keywords: 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Polysomnography; Brain; Humans; REM Sleep Behavior Disorder; Magnetic Resonance Imaging

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