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快速眼动睡眠行为障碍筛查问卷在帕金森病中的诊断价值

Diagnostic value of the REM sleep behavior disorder screening questionnaire in Parkinson's disease.

作者信息

Stiasny-Kolster Karin, Sixel-Döring Friederike, Trenkwalder Claudia, Heinzel-Gutenbrunner Monika, Seppi Klaus, Poewe Werner, Högl Birgit, Frauscher Birgit

机构信息

Somnomar, Institute for Medical Research and Sleep Medicine, Marburg, Germany; Philipps-University, Marburg, Germany.

Paracelsus-Elena Klinik, Kassel, Germany.

出版信息

Sleep Med. 2015 Jan;16(1):186-9. doi: 10.1016/j.sleep.2014.08.014. Epub 2014 Nov 13.

Abstract

OBJECTIVE

We aimed to validate the rapid eye movement (REM) sleep behavior disorder (RBD) screening questionnaire (RBDSQ) in 2 independent samples of patients with Parkinson's disease (PD) using different settings when performing the investigations.

METHODS

The RBDSQ was administered to two independent samples of 52 and 75 consecutive PD patients investigated with video-polysomnography (vPSG).

RESULTS

In sample A, the RBDSQ identified 46/52 (88.5%) patients correctly. In sample B, 50/75 (66.7%) patients were identified correctly. Considering a cut-off score of ≥ 5 as a positive test result, sample A showed a sensitivity of 0.90 and a specificity of 0.87, sample B showed a sensitivity of 0.68 and a specificity of 0.63. Main differences between both groups were that patients of sample A underwent a sleep history including RBD assessment prior to administration of the RBDSQ, whereas in sample B the RBDSQ was administered during routine work-up.

CONCLUSIONS

The diagnostic value of the RBDSQ strongly depends on the clinical setting and may be influenced by the individual's awareness on RBD. This finding is a critical issue which deserves clarification before use of this and other questionnaires can be recommended in epidemiological studies.

摘要

目的

我们旨在通过在不同调查环境下对两个独立的帕金森病(PD)患者样本进行研究,来验证快速眼动(REM)睡眠行为障碍(RBD)筛查问卷(RBDSQ)。

方法

将RBDSQ应用于两个独立样本,分别为52例和75例连续接受视频多导睡眠图(vPSG)检查的PD患者。

结果

在样本A中,RBDSQ正确识别出46/52(88.5%)的患者。在样本B中,正确识别出50/75(66.7%)的患者。将截断分数≥5作为阳性检测结果,样本A的敏感性为0.90,特异性为0.87,样本B的敏感性为0.68,特异性为0.63。两组之间的主要差异在于,样本A中的患者在进行RBDSQ之前接受了包括RBD评估在内的睡眠史调查,而在样本B中,RBDSQ是在常规检查期间进行的。

结论

RBDSQ的诊断价值很大程度上取决于临床环境,并且可能受到个体对RBD认知的影响。这一发现是一个关键问题,在流行病学研究中推荐使用该问卷及其他问卷之前,值得进一步阐明。

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