Neurodegeneration
This is a pilot study in which we will try and understand that are the first signs of neurodegeneration in a condition named isolated REM sleep behaviour disorder, which often is the very first sign of more progressive conditions such as Parkinson’s disease.
I will enroll a group of patients with a diagnosis of iRBD. To make sure they are at a very early stage, I will conduct a series of clinical assessment with some tests and scales evaluating a series of symptoms known to be “prodromal” of Parkinson’s disease (such as depression, problems with the smell etc.), and I will conduct one [123I]FP-CIT SPECT scan. This scan measures the levels of dopamine in the brain and is typically altered in patients who already have PD. I will enroll only iRBD patients with a normal scan (i.e. with normal levels of dopamine in the brain). Then as part of the study, I will ask participants to undergo one PET scan with the [18F]FDG tracer, that measures the level of activity of the brain cells, and one MRI scan, with sequences able to identify subtle changes in the content of iron, in the flow of water, and other elements that have been put in relationship with the onset of neurodegeneration.
If the research is successful, we will be able to 1) identify when, where, and how the first alterations take place in iRBD; 2) identify a test, or a series of tests that can be employed on a larger scale, to study the same alterations in future studies; 3) understand whether and how the early changes identified as part of this study could be influenced, or even reverted by the use of pharmacological therapies.
This research is funded by the NIHR Exeter BRC as part of the Small Projects Grant.
Dr Edoardo de Natale, Dr Heather Wilson, Prof Marios Politis.
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