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Abstract #2601

Investigating premanifest synucleinopathy: structural connectome of brainstem nuclei in REM sleep behavior disorder

Maria Guadalupe Garcia Gomar1,2, Laura Lewis1,2, Lawrence Wald1,2, Bruce Rosen1,2, Aleksandar Videnovic2,3, and Marta Bianciardi1,2

1Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States, 2Harvard Medical School, Boston, MA, United States, 3Neurology, Massachusetts General Hospital, Boston, MA, United States

REM-sleep-behavior-disorder (RBD) is characterized by the absence of muscle-atonia during REM-sleep. RBD is strongly associated with presymptomatic-manifestations of neurodegenerative-synucleinopathies. Thus, it allows the investigation of early/premanifest neurodegenerative-stages when treatment can be most effective in delaying the development of full-blown-disease. Changes in brainstem-nuclei-connectivity are expected in RBD/premanifest-synucleinopathy based on animal- and ex-vivo-human-studies. Yet, their investigation in living-humans is understudied. Through high-spatial-resolution 7Tesla-MRI and a recently-developed probabilistic-brainstem-nuclei-atlas, we built a brainstem-based structural-connectome in living RBD-patients and age-matched controls. Interestingly, in RBD-patients we detected structural-connectivity-changes within the brainstem, with the striatum and cerebellum in line with the pathophysiology of RBD in animal-models.

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