{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:03:36Z","timestamp":1790899416394,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004836","name":"Danmarks Frie Forskningsfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Reduced cortical acetylcholinesterase activity, as measured by <jats:sup>11<\/jats:sup>C\u2010donepezil positron emission tomography (PET), has been reported in patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD). However, its progression and clinical implications have not been fully investigated. Here, we explored the relationship between longitudinal changes in brain acetylcholinesterase activity and cognitive function in iRBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twelve iRBD patients underwent <jats:sup>11<\/jats:sup>C\u2010donepezil PET at baseline and after 3\u2009years. PET images were interrogated with statistical parametric mapping (SPM) and a regions of interest (ROI) approach. Clinical progression was assessed with the Movement Disorder Society\u2010Unified Parkinson's Disease Rating Scale\u2010Part III (MDS\u2010UPDRS\u2010III). Cognitive function was rated using the Mini\u2010Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From baseline to follow\u2010up, the mean <jats:sup>11<\/jats:sup>C\u2010donepezil distribution volume ratio (DVR) decreased in the cortex (<jats:italic>p<\/jats:italic>\u2009=\u20090.006), thalamus (<jats:italic>p<\/jats:italic>\u2009=\u20090.013), and caudate (<jats:italic>p<\/jats:italic>\u2009=\u20090.013) ROI. Despite no significant changes in the group mean MMSE or MoCA scores being observed, individually, seven patients showed a decline in their scores on these cognitive tests. Subgroup analysis showed that only the subgroup of patients with a decline in cognitive scores had a significant reduction in mean cortical <jats:sup>11<\/jats:sup>C\u2010donepezil DVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show that severity of brain cholinergic dysfunction in iRBD patients increases significantly over 3\u2009years, and those changes are more severe in those with a decline in cognitive test scores.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16101","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T14:25:03Z","timestamp":1697552703000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Progression of brain cholinergic dysfunction in patients with isolated rapid eye movement sleep behavior disorder"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-242X","authenticated-orcid":false,"given":"Kristian","family":"St\u00e6r","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET, Institute of Clinical Medicine Aarhus University  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5618-8271","authenticated-orcid":false,"given":"Alex","family":"Iranzo","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Cl\u00ednic, IDIBAPS Universitat de Barcelona  Catalonia Spain"},{"name":"Sleep Disorders Center Hospital Clinic  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0971-3747","authenticated-orcid":false,"given":"Miriam H\u00f8jholt","family":"Terkelsen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET, Institute of Clinical Medicine Aarhus University  Aarhus N Denmark"},{"name":"Department of Neurology Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Gersel","family":"Stokholm","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET, Institute of Clinical Medicine Aarhus University  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik Hvid","family":"Danielsen","sequence":"additional","affiliation":[{"name":"Department of Neurology Aarhus University Hospital  Aarhus N 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