Pena-Pereira Márcio Alexandre, Sobreira-Neto Manoel Alves, Sobreira Emmanuelle, Chagas Marcos Hortes Nisihara, Oliveira Daniel Sabino de, Rodrigues Guilherme Riccioppo, Souza Carolina Pinto de, Eckeli Alan Luiz, Fernandes Regina Maria França, Tumas Vitor
Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto, São Paulo SP, Brazil.
Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza CE, Brazil.
Arq Neuropsiquiatr. 2020 Oct;78(10):629-637. doi: 10.1590/0004-282X20200125. Epub 2020 Oct 28.
A diagnosis of rapid eye movement sleep behavior disorder (RBD) currently requires confirmation with polysomnography (PSG). However, PSG may not be sufficiently available. In these situations, a clinical diagnostic measure might be useful.
To validate the Brazilian Portuguese version of RBD screening questionnaire (RBDSQ) for patients with Parkinson's disease (PD).
Using detailed clinical interviews and PSG analysis (diagnostic gold standard), a convenience sample of 69 subjects was divided into the following subgroups: patients with PD and RBD (PD+RBD; n=50) and patients with PD alone (PD-RBD; n=19).
RBDSQ-BR showed adequate internal consistency (Cronbach's α=0.809) and, except for item 8, adequate item-test correlation. The retest performed in a second sample (n=13, consecutive) showed high agreement for total score (intraclass correlation coefficient, ICC=0.863) and acceptable agreement for items 2, 3, 6.2, 6.3, 7, and 8 (K>0.60). The receiver operating characteristic (ROC) curve analysis had an area under the curve (AUC) of 0.728. A cut-off score of 4 enabled the correct diagnosis of 76.8% subjects and provided the best balance between sensitivity (84%) and specificity (57.9%), with a 2.0 likelihood ratio of a positive result (LR+) and a 0.3 likelihood ratio of a negative result (LR-). Items 2 and 6.2 had 84.2% specificity and 3.2 LR+. Combined items 1+2+6.2, 2+6.1, and 6.1+6.2 increased the specificity to 94.7%, with LR+ ranging from 6.1 to 7.6.
RBDSQ-BR is a reliable instrument, which may be useful for RBD diagnosis of Brazilian patients with PD. The instrument is also valid and may help in a better selection of cases for a more detailed clinical evaluation or even PSG analysis.
目前快速眼动睡眠行为障碍（RBD）的诊断需要通过多导睡眠图（PSG）来确认。然而，PSG可能无法充分获取。在这些情况下，临床诊断措施可能会有所帮助。
验证巴西葡萄牙语版帕金森病（PD）患者RBD筛查问卷（RBDSQ）。
通过详细的临床访谈和PSG分析（诊断金标准），将69名受试者的便利样本分为以下亚组：PD合并RBD患者（PD+RBD；n=50）和单纯PD患者（PD-RBD；n=19）。
RBDSQ-BR显示出足够的内部一致性（Cronbach's α=0.809），除第8项外，各项目与测试的相关性也足够。在第二个样本（n=13，连续样本）中进行的重测显示，总分的一致性较高（组内相关系数，ICC=0.863），第2、3、6.2、6.3、7和8项的一致性可接受（K>0.60）。受试者工作特征（ROC）曲线分析的曲线下面积（AUC）为0.728。截断分数为4时，能正确诊断76.8%的受试者，并在敏感性（84%）和特异性（57.9%）之间提供了最佳平衡，阳性结果的似然比为2.0（LR+），阴性结果的似然比为0.3（LR-）。第2项和6.2项的特异性为84.2%，LR+为3.2。组合项目1+2+6.2、2+6.1和6.1+6.2的特异性提高到94.7%，LR+范围为6.1至7.6。
RBDSQ-BR是一种可靠的工具，可用于巴西PD患者的RBD诊断。该工具也是有效的，有助于更好地选择病例进行更详细的临床评估甚至PSG分析。
