Actigraphy as a diagnostic aid for REM sleep behavior disorder in Parkinson’s disease
Tóm tắt
Rapid eye movement (REM) sleep behavior disorder (RBD) is a common parasomnia in Parkinson’s disease (PD) patients. The current International Classification of Sleep Disorders (ICSD-II) requires a clinical interview combined with video polysomnography (video-PSG) to diagnose. The latter is time consuming and expensive and not always feasible in clinical practice. Here we studied the use of actigraphy as a diagnostic tool for RBD in PD patients. We studied 45 consecutive PD patients (66.7% men) with and without complaints of RBD. All patients underwent one night of video-PSG and eight consecutive nights of actigraphy. Based on previous studies, the main outcome measure was the total number of bouts classified as “wake”, compared between patients with (PD + RBD) and without RBD (PD- RBD). 23 (51.1%) patients had RBD according to the ICSD-II criteria. The total number of wake bouts was significantly higher in RBD patients (PD + RBD 73.2 ± 40.2 vs. PD-RBD 48.4 ± 23.3, p = .016). A cut off of 95 wake bouts per night resulted in a specificity of 95.5%, a sensitivity of 20.1% and a positive predictive value of 85.7%. Seven patients were suspected of RBD based on the interview alone, but not confirmed on PSG; six of whom scored below 95 wake bouts per night on actigraphy. PD patients with RBD showed a significantly higher number of bouts scored as “wake” using actigraphy, compared to patients without RBD. In clinical practice, actigraphy has a high specificity, but low sensitivity in the diagnosis of RBD. The combination of actigraphy and previously reported RBD questionnaires may be a promising method to diagnose RBD in patients with PD.
Tài liệu tham khảo
Comella CL, Nardine TM, Diederich NJ, Stebbins GT: Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology. 1998, 51 (2): 526-529. 10.1212/WNL.51.2.526.
Gagnon JF, Bedard MA, Fantini ML, Petit D, Panisset M, Rompre S, Carrier J, Montplaisir J: REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology. 2002, 59 (4): 585-589. 10.1212/WNL.59.4.585.
Gjerstad MD, Boeve B, Wentzel-Larsen T, Aarsland D, Larsen JP: Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson’s disease over time. J Neurol Neurosurg Psychiatry. 2008, 79 (4): 387-391. 10.1136/jnnp.2007.116830.
De Cock VC, Vidailhet M, Leu S, Texeira A, Apartis E, Elbaz A, Roze E, Willer JC, Derenne JP, Agid Y, Arnulf I: Restoration of normal motor control in Parkinson’s disease during REM sleep. Brain. 2007, 130 (Pt 2): 450-456.
American Academy of Sleep Medicine: The International Classification of Sleep Disorders. 2005, Westchester, IL: American Academy of Sleep Medicine, Second
Eisensehr I, V Lindeiner H, Jager M, Noachtar S: REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson’s disease: is there a need for polysomnography?. J Neurol Sci. 2001, 186 (1–2): 7-11.
Iranzo A, Santamaria J: Severe obstructive sleep apnea/hypopnea mimicking REM sleep behavior disorder. Sleep. 2005, 28 (2): 203-206.
Stiasny-Kolster K, Mayer G, Schafer S, Moller JC, Heinzel-Gutenbrunner M, Oertel WH: The REM sleep behavior disorder screening questionnaire–a new diagnostic instrument. Mov disord Official J Mov Disord Soc. 2007, 22 (16): 2386-2393. 10.1002/mds.21740.
Chahine LM, Daley J, Horn S, Colcher A, Hurtig H, Cantor C, Dahodwala N: Questionnaire-based diagnosis of REM sleep behavior disorder in Parkinson’s disease. Mov. Disord Official J Mov Disord Soc. 2013, Epub ahead of print
Sasai T, Matsuura M, Wing YK, Inoue Y: Validation of the Japanese version of the REM sleep behavior disorder questionnaire (RBDQ-JP). Sleep Med. 2012, 13 (7): 913-918. 10.1016/j.sleep.2012.04.011.
Li SX, Wing YK, Lam SP, Zhang J, Yu MW, Ho CK, Tsoh J, Mok V: Validation of a new REM sleep behavior disorder questionnaire (RBDQ-HK). Sleep Med. 2010, 11 (1): 43-48. 10.1016/j.sleep.2009.06.008.
Frauscher B, Ehrmann L, Zamarian L, Auer F, Mitterling T, Gabelia D, Brandauer E, Delazer M, Poewe W, Hogl B: Validation of the Innsbruck REM sleep behavior disorder inventory. Mov Disord Official J Mov Disord Soc. 2012, 27 (13): 1673-1678. 10.1002/mds.25223.
Stavitsky K, Saurman JL, McNamara P, Cronin-Golomb A: Sleep in Parkinson’s disease: a comparison of actigraphy and subjective measures. Parkinsonism Relat Disord. 2010, 16 (4): 280-283. 10.1016/j.parkreldis.2010.02.001.
Maglione JE, Liu L, Neikrug AB, Poon T, Natarajan L, Calderon J, Avanzino JA, Corey-Bloom J, Palmer BW, Loredo JS, Ancoli-Isreal S: Actigraphy for the assessment of sleep measures in Parkinson’s disease. Sleep. 2013, 36 (8): 1209-1217.
Naismith SL, Rogers NL, Mackenzie J, Hickie IB, Lewis SJ: The relationship between actigraphically defined sleep disturbance and REM sleep behaviour disorder in parkinson’s disease. Clin Neurol Neurosurg. 2010, 112 (5): 420-423. 10.1016/j.clineuro.2010.02.011.
Hoehn MM, Yahr MD: Parkinsonism: onset, progression and mortality. Neurology. 1967, 17 (5): 427-442. 10.1212/WNL.17.5.427.
Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE: Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord Official J Mov Disord Soc. 2010, 25 (15): 2649-2653. 10.1002/mds.23429.
Frauscher B, Iranzo A, Gaig C, Gschliesser V, Guaita M, Raffelseder V, Ehrmann L, Sola N, Salamero M, Tolosa E, Poewe W, Santamaria J, Högl B, SINBAR (Sleep Innsbruck Barcelona) Group: Normative EMG values during REM sleep for the diagnosis of REM sleep behavior disorder. Sleep. 2012, 35 (6): 835-847.
Ohayon MM, Caulet M, Priest RG: Violent behavior during sleep. J Clin Psychiat. 1997, 58 (8): 369-376. quiz 377
Chiu HF, Wing YK, Lam LC, Li SW, Lum CM, Leung T, Ho CK: Sleep-related injury in the elderly–an epidemiological study in Hong Kong. Sleep. 2000, 23 (4): 513-517.
Lapierre O, Montplaisir J: Polysomnographic features of REM sleep behavior disorder: development of a scoring method. Neurology. 1992, 42 (7): 1371-1374. 10.1212/WNL.42.7.1371.
Arnulf I, Merino-Andreu M, Bloch F, Konofal E, Vidailhet M, Cochen V, Derenne JP, Agid Y: REM sleep behavior disorder and REM sleep without atonia in patients with progressive supranuclear palsy. Sleep. 2005, 28 (3): 349-354.
Ferri R, Manconi M, Plazzi G, Bruni O, Vandi S, Montagna P, Ferini-Strambi L, Zucconi M: A quantitative statistical analysis of the submentalis muscle EMG amplitude during sleep in normal controls and patients with REM sleep behavior disorder. J Sleep Res. 2008, 17 (1): 89-100. 10.1111/j.1365-2869.2008.00631.x.
Mayer G, Kesper K, Ploch T, Canisius S, Penzel T, Oertel W, Stiasny-Kolster K: Quantification of tonic and phasic muscle activity in REM sleep behavior disorder. J Clin Neurophysiol Official Publication Am Electroencephalograph Soc. 2008, 25 (1): 48-55. 10.1097/WNP.0b013e318162acd7.
Bliwise DL, Trotti LM, Greer SA, Juncos JJ, Rye DB: Phasic muscle activity in sleep and clinical features of Parkinson disease. Ann Neurol. 2010, 68 (3): 353-359. 10.1002/ana.22076.
Montplaisir J, Gagnon JF, Fantini ML, Postuma RB, Dauvilliers Y, Desautels A, Rompre S, Paquet J: Polysomnographic diagnosis of idiopathic REM sleep behavior disorder. Mov Disord Official J Mov Disord Soc. 2010, 25 (13): 2044-2051. 10.1002/mds.23257.
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