MRI Study of Brain Activity in Healthy Adults and Individuals With Parkinsonism and Rapid Eye Movement Disorder.

Study Overview
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Brief Summary
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This proposal is focused on developing a reliable, valid, and reproducible imaging techniques and statistical methodology for segregation of various forms of Parkinsonism from healthy adults without Parkinsonism.

Detailed Description
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This proposal is focused on developing a reliable, valid, and reproducible imaging techniques and statistical methodology for segregation of various forms of Parkinsonism from healthy adults without Parkinsonism. We focus on early diagnosis of Parkinsonism, other tremor disorders, and determine how imaging might be used to improve diagnosis. The purpose of this protocol is to gather a multi-modal dataset to explore and validate the investigator's previous research findings in prior studies.

Official Title
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Statistical Mapping of the Brain in Progressive Supranuclear Palsy, Essential Tremor, Parkinson Disease, Parkinsonism, and REM Behavior Disorder

Conditions
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Movement Disorders (Incl Parkinsonism), Tremor Familial Essential, 1, REM Sleep Behavior Disorder

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy Control • Age 35-85 Parkinson Disease (PD) Age 35-85 Diagnosis of clinically definite PD made by a movement disorders specialist, with evidence of the following features: Presence of bradykinesia and 1 or both of the following: Rest tremor Rigidity Asymmetric Onset Progressive motor symptoms Levodopa responsive Duration at least 1 but not more than 10 years Hoehn and Yahr Stage 1-2 Progressive Supranuclear Palsy (PSP) Age 40-85 Diagnosis of clinically definite PSP, with the following features: Gradually progressive disorder. Onset after age 39 Supranuclear palsy* and postural instability with falls in the first year of disease onset*. No evidence of other disease. Parkinsonism of Other or Undetermined Cause (POC) Age 35-85 Diagnosis of parkinsonism of undetermined other other cause by a movement disorders specialist, with the following features: Signs and symptoms of Parkinsonism including Bradykinesia Mixed or resting tremor Rigidity Characteristic deficits of gait and balance associated with Parkinsonism Essential Tremor (ET) Age 35-85 Diagnosis of essential tremor, with the following features: A 2+ postural tremor of at least 1 arm (a head tremor may also be present, but is not sufficient for diagnosis) On examination, there must be a 2+ kinetic tremor during at least 4 tasks, or; a 2+ kinetic tremor on 1 task and a 3+ kinetic tremor on a second task; tasks include pouring water, using a spoon to drink water, drinking water, finger-to-nose, and drawing a spiral If on examination, the tremor is present in the dominant hand, then by report, it must interfere with at least 1 activity of daily living. REM Behavior Disorder (RBD) Age 25 - 85 Documented diagnosis of REM sleep behavior disorder (RBD) by a sleep medicine specialist, with the following clinical features: Presence of REM sleep without atonia on polysomnography At least one of the following conditions: Sleep-related, behaviors by history (eg, dream enactment behavior) Abnormal REM sleep behavior documented during PSG monitoring Exclusion Criteria: Healthy Control Pregnancy First-degree blood relative affected by PD Neurodegenerative disease History of repeated head injury, encephalitis, brain surgery, stroke, dementia, neuroleptic exposure, or serious medical illness that may interfere with participation. Parkinson Disease (PD) Any exclusion criteria that would exclude a healthy control patient Atypical features indicative of a Parkinson-Plus disorder Progressive Supranuclear Palsy (PSP) Any exclusion criteria that would exclude a healthy control patient Any finding atypical for PSP Neuroradiologic evidence of relevant structural abnormality unrelated to appropriate changes known to be associated with PSP Parkinsonism of Other or Undetermined Cause (POC) Any exclusion criteria that would exclude a healthy control patient Signs and symptoms suggestive of clear diagnosis of idiopathic Parkinson disease, Progressive Supranuclear Palsy, or Essential Tremor Essential Tremor (ET) Any exclusion criteria that would exclude a healthy control patient No other potential etiologic factors for the tremor Any first-degree blood relative affected by PD History of neurodegenerative disease REM Behavior Disorder (RBD) Any exclusion criteria that would exclude a healthy control patient Sleep disorder not better explained by another sleep disorder, medical or neurological disorder, mental disorder, medication use, or substance use disorder

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Parkinson's Disease Cohort<br>Individuals Diagnosed with Parkinson's Disease | |
| Essential Tremor cohort<br>Individuals Diagnosed with Essential Tremor | |
| Rapid Eye Movement Disorder Cohort<br>Individuals Diagnosed with Rapid-Eye Movement Behavior Disorder (RBD). Eligible individuals will have been diagnosed with RBD based on a sleep study prior to entering the study. This study does not pay for or support a sleep study. | |
| Healthy Control group<br>Individuals are healthy, without a known neurologic disease. | |
| Progressive Supranuclear Palsy Cohort<br>Individuals diagnosed with Progressive Supranuclear Palsy (PSP). | |
| Parkinsonism - Undifferentiated<br>Individuals with any form of Parkinsonism, not meeting any of the above cohorts. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fMRI compared between cohorts | Studying resting brain activity between healthy adults, participants with Parkinson's and participants with REM Behavior Disorder. | one time at initial visit |