Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.
Sleep. 2021 Jun 11;44(6). doi: 10.1093/sleep/zsaa294.
To provide an overall estimate of the prevalence of idiopathic REM Sleep Behavior Disorder (iRBD).
Two investigators have independently searched the PubMed and Scopus databases for population-based studies assessing the prevalence of iRBD. Data about type of diagnosis (polysomnographic diagnosis, defined iRBD [dRBD]; clinical diagnosis, probable RBD [pRBD]), continent, age range of the screened population, quality of the studies, sample size, screening questionnaires, and strategies have been gathered. A random-effect model was used to estimate the pooled prevalence. Heterogeneity was investigated with subgroup analysis and meta-regression.
From 857 articles found in the databases, 19 articles were selected for the systematic review and meta-analysis. According to the type of diagnosis, five studies identified dRBD cases given a pooled prevalence of 0.68% (95% confidence interval [CI] 0.38-1.05) without significant heterogeneity (Cochran's Q p = 0.11; I2 = 46.43%). Fourteen studies assessed the prevalence of pRBD with a pooled estimate of 5.65% (95% CI 4.29-7.18) and a significant heterogeneity among the studies (Cochran's Q p < 0.001; I2 = 98.21%). At the subgroup analysis, significant differences in terms of prevalence were present according to the quality of the studies and, after removing two outlaying studies, according to the continents and the screening questionnaire used. Meta-regression did not identify any significant effect of the covariates on the pooled estimates.
Prevalence estimates of iRBD are significantly impacted by diagnostic level of certainty. Variations in pRBD prevalence are due to methodological differences in study design and screening questionnaires employed.
提供特发性 REM 睡眠行为障碍（iRBD）患病率的总体估计。
两位研究者分别独立检索了 PubMed 和 Scopus 数据库中评估 iRBD 患病率的基于人群的研究。收集了有关诊断类型（多导睡眠图诊断，定义为 iRBD [dRBD]；临床诊断，可能的 RBD [pRBD]）、大陆、筛查人群的年龄范围、研究质量、样本量、筛查问卷和策略的数据。使用随机效应模型估计汇总患病率。通过亚组分析和荟萃回归调查异质性。
从数据库中的 857 篇文章中，选择了 19 篇进行系统评价和荟萃分析。根据诊断类型，五项研究确定了 dRBD 病例，其汇总患病率为 0.68%（95%置信区间 [CI] 0.38-1.05），异质性无统计学意义（Cochran's Q p = 0.11；I2 = 46.43%）。十四项研究评估了 pRBD 的患病率，汇总估计值为 5.65%（95% CI 4.29-7.18），研究之间存在显著异质性（Cochran's Q p < 0.001；I2 = 98.21%）。在亚组分析中，根据研究质量，患病率存在显著差异，在排除两项离群研究后，根据大陆和使用的筛查问卷，患病率也存在差异。荟萃回归未发现协变量对汇总估计值有任何显著影响。
iRBD 的患病率估计受到诊断确定性水平的显著影响。pRBD 患病率的差异是由于研究设计和使用的筛查问卷在方法学上的差异造成的。
