• María José Abenza Abildua, Elvira Lanz Santos, Luis Moreno Domínguez, Marina Mata Álvarez-Santullano, Carmen Borrue Fernández, Itziar Palmí Cortés, Ricardo Lobato Rodríguez, Francisco José Navacerrada Barrero, Sonia Martínez Ubierna, Ángeles Gómez Aceña A, Eugenio Suárez Gisbert, Vanesa Lores Gutiérrez, Álvaro Gómez de la Riva, Pérez LópezCarlosCServicio de Neurocirugía, Complejo Hospital Universitario La Paz-Cantoblanco-CarlosIII, Madrid, España., and Susana Novo Aparicio.
• Unidad del Sueño, Sección de Neurología, Hospital Universitario Infanta Sofía. Fundación para la Investigación e Innovación Biomédica del Hospital Universitario Infanta Sofía y Hospital Universitario del Henares, Madrid, España. Electronic address: mjose.abenza@salud.madrid.org.
• Med Clin (Barc). 2024 Jul 26; 163 (2): 707370-73.

IntroductionThe presence of cortical atrophy (focal or diffuse) prior to the development of symptoms of cognitive impairment could predict the earliest cases of neurodegenerative disease in patients with REM sleep behavior disorder (RSBD). We reviewed the usefulness of cranial CT and MRI as early markers of cortical atrophy in patients with RSBD at our center.Patients And MethodsRetrospective observational descriptive analysis of patients diagnosed with RSBD from October 2012 to October 2022. All with cranial CT or MRI, evaluated by a neuroradiologist.Results54 patients were included, 21 women (38.88%), 33 men (61.12%), mean age at diagnosis of RSBD: 69.04±12.625 years. Of the 54 patients, 44 (81.48%) had imaging tests consistent with their age, and 10 had atrophy greater than expected for their age. Of the 54 patients, 21 (38.88%) with a diagnosis of neurodegenerative disease, 33 (61.12%) persist as idiopathic, almost all with more than 5years of evolution (range of 1 to 10years of evolution without diagnosis). Of the 10 (18.52%) patients with greater atrophy, all were diagnosed with neurodegenerative disease (8 in 1year, 2 in 8years).ConclusionsAlmost half of our series have developed a neurodegenerative disease in the first 10years of evolution. The majority of them presented global cortical atrophy measured by the GCA scale in the first year of diagnosis, without other neurological symptoms. Patients who did not show cortical atrophy at diagnosis have not yet developed the neurodegenerative disease in 10years of evolution. In our experience, the absence of cortical atrophy on cranial MRI or CT (measured by scales such as GCA) at the diagnosis of RSBD seems to predict slower progression cases. These data should be corroborated with larger series.Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

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