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

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:

  1. Rest tremor
  2. 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

  1. Bradykinesia
  2. Mixed or resting tremor
  3. Rigidity

  4. 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

  1. a 2+ kinetic tremor during at least 4 tasks, or;
  2. 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:

  1. Sleep-related, behaviors by history (eg, dream enactment behavior)
  2. 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