Iron Accumulation in Subcortical Structures and its Correlation with Cognitive Decline in Idiopathic REM Sleep Behavior Disorder

Motivation: Idiopathic REM Sleep Behavior Disorder (iRBD) is the prodromal syndrome of α-synucleinopathies whose conversion is difficult to predict. Goal(s): The goal was to study iron accumulation in the brains of patients and its clinical correlation with neuropsychological test. Approach: 20 patients underwent MRI protocol that included a QSM and a neuropsychological evaluation. The susceptibility values were compared with a group of healthy volunteers and correlated with neuropsychological tests. Results: Significant increase of iron deposition resulted in brainstem and in gray matter nuclei and positive correlation resulted between deterioration of visual-constructive and executive functions and magnetic susceptibility in substantia nigra and red nuclei. Impact: Iron accumulation in the brain can serve as an early warning sign for neurodegenerative diseases linked to idiopathic REM Sleep Behavior Disorder (iRBD), indicating cognitive decline and behavioral issues. This may offer a non-invasive means to identify individuals at risk.