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@ARTICLE{Seger:1018436,
      author       = {Seger, Aline and Ophey, Anja and Doppler, Christopher E. J.
                      and Kickartz, Johanna and Lindner, Marie-Sophie and
                      Hommelsen, Maximilian and Fink, Gereon R. and Sommerauer,
                      Michael},
      title        = {{C}linical subtypes in patients with isolated {REM} sleep
                      behaviour disorder},
      journal      = {npj Parkinson's Disease},
      volume       = {9},
      number       = {1},
      issn         = {2373-8057},
      address      = {London [u.a.]},
      publisher    = {Nature Publ. Group},
      reportid     = {FZJ-2023-04811},
      pages        = {155},
      year         = {2023},
      abstract     = {Patients with Parkinson's disease (PD) show a broad
                      heterogeneity in dinical presentation, and subtypes may
                      already arise inprodromal disease stages. lsolated REM sleep
                      behaviour disorder (iRBD) is the most specific marker of
                      prodromal PD, but data ondinical subtyping of patients with
                      iRBD remain scarce. Therefore, this study aimed to identify
                      iRBD subtypes. We conductedcomprehensive dinical assessments
                      in 66 patients with polysomnography-proven iRBD, induding
                      motor and non-motorevaluations, and applied a two-step
                      duster analysis. Besides, we compared iRBD dusters to
                      matched healthy controls and relatedthe resulting duster
                      solution to cortical and subcortical grey matter volumes by
                      voxel-based morphometry analysis. We identifiedtwo distinct
                      subtypes of patients based on olfactory function, dominant
                      electroencephalography frequency, amount of REM sleepwithout
                      atonia, depressive symptoms, disease duration, and motor
                      functions. One iRBD duster (Cluster 1, late
                      onset-aggressive)was characterised by higher non-motor
                      symptom burden despite shorter disease duration than the
                      more benign subtype (Cluster II,early onset-benign). Motor
                      functions were comparable between the dusters. Patients from
                      Cluster I were significantly older atiRBD onset and
                      exhibited a widespread reduction of cortical grey matter
                      volume compared to patients from Cluster II. In
                      condusion,our findings suggest the existence of dinical
                      subtypes already in the prodromal stage of PD. Future
                      longitudinal studies arewarranted that replicate these
                      findings and investigate the risk of the more aggressive
                      phenotype for earlier phenoconversion anddementia
                      development.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525) / DFG
                      project 431549029 - SFB 1451: Schlüsselmechanismen normaler
                      und krankheitsbedingt gestörter motorischer Kontrolle
                      (431549029) / DFG project 491111487 -
                      Open-Access-Publikationskosten / 2022 - 2024 /
                      Forschungszentrum Jülich (OAPKFZJ) (491111487)},
      pid          = {G:(DE-HGF)POF4-5252 / G:(GEPRIS)431549029 /
                      G:(GEPRIS)491111487},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {37978183},
      UT           = {WOS:001104547000001},
      doi          = {10.1038/s41531-023-00598-7},
      url          = {https://juser.fz-juelich.de/record/1018436},
}