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

• Published in: Sleep medicine Vol. 79; pp. 88 - 93
• Main Authors: Byun, Jung-Ick, Cha, Kwang Su, Kim, Minah, Lee, Woo-Jin, Lee, Han Sang, Sunwoo, Jun-Sang, Shin, Jung-Won, Kim, Tae-Joon, Moon, Jangsup, Lee, Soon-Tae, Jung, Keun-Hwa, Chu, Kon, Kim, Man-Ho, Kim, Han-Joon, Shin, Won Chul, Lee, Sang Kun, Jung, Ki-Young
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2021
• Subjects: Cognitive function; Functional brain imaging; Multivariate pattern analysis (MVPA); Neuroimaging; REM sleep Behavior disorder; Neuroimaging; Functional brain imaging; Multivariate pattern analysis (MVPA); REM sleep Behavior disorder; Cognitive function
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2020.12.038

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.
•MVPA of whole brain FC revealed posterior insula to be associated with iRBD.•FC between the insula and precuneus was reduced in iRBD.•The degree of insula-precuneus FC was positively correlated with MoCA score in iRBD.