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基于国际睡眠障碍分类第三版(ICSD - 3)临床文本的睡眠障碍诊断标准症状网络分析

Symptom network analysis of the sleep disorders diagnostic criteria based on the clinical text of the ICSD-3.

作者信息

Gauld Christophe, Lopez Régis, Morin Charles, Geoffroy Pierre A, Maquet Julien, Desvergnes Pierre, McGonigal Aileen, Dauvilliers Yves, Philip Pierre, Dumas Guillaume, Micoulaud-Franchi Jean-Arthur

机构信息

Department of Psychiatry, University of Grenoble, Grenoble, France.

UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France.

出版信息

J Sleep Res. 2022 Feb;31(1):e13435. doi: 10.1111/jsr.13435. Epub 2021 Jul 16.

Abstract

The third edition of the International Classification of Sleep Disorders (ICSD-3) is the authoritative clinical text for the diagnosis of sleep disorders. An important issue of sleep nosology is to better understand the relationship between symptoms found in conventional diagnostic manuals and to compare classifications. Nevertheless, to our knowledge, there is no specific exhaustive work on the general structure of the networks of symptoms of sleep disorders as described in diagnostic manuals. The general aim of the present study was to use symptom network analysis to explore the diagnostic criteria in the ICSD-3 manual. The ICSD-3 diagnostic criteria related to clinical manifestations were systematically identified, and the units of analysis (symptoms) were labelled from these clinical manifestation diagnostic criteria using three rules ("Conservation", "Splitting", "Lumping"). A total of 37 of the 43 main sleep disorders with 160 units of analysis from 114 clinical manifestations in the ICSD-3 were analysed. A symptom network representing all individual ICSD-3 criteria and connections between them was constructed graphically (network estimation), quantified with classical metrics (network inference with global and local measures) and tested for robustness. The global measure of the sleep symptoms network shows that it can be considered as a small world, suggesting a strong interconnection between symptoms in the ICSD-3. Local measures show the central role of three kinds of bridge sleep symptoms: daytime sleepiness, insomnia, and behaviour during sleep symptoms. Such a symptom network analysis of the ICSD-3 structure could provide a framework for better systematising and organising symptomatology in sleep medicine.

摘要

《国际睡眠障碍分类》(ICSD - 3)第三版是诊断睡眠障碍的权威临床文本。睡眠疾病分类学的一个重要问题是更好地理解传统诊断手册中发现的症状之间的关系,并比较不同的分类方法。然而,据我们所知,目前还没有针对诊断手册中所描述的睡眠障碍症状网络的总体结构进行具体详尽的研究。本研究的总体目标是使用症状网络分析来探索ICSD - 3手册中的诊断标准。系统地确定了与临床表现相关的ICSD - 3诊断标准,并使用三条规则(“保留”“拆分”“合并”)从这些临床表现诊断标准中标记出分析单元(症状)。对ICSD - 3中43种主要睡眠障碍中的37种进行了分析,这些睡眠障碍包含来自114种临床表现的160个分析单元。以图形方式构建了一个代表所有ICSD - 3个体标准及其之间联系的症状网络(网络估计),用经典指标进行量化(使用全局和局部测量进行网络推断)并测试其稳健性。睡眠症状网络的全局测量表明它可被视为一个小世界网络,这表明ICSD - 3中的症状之间存在很强的相互联系。局部测量显示了三种桥梁性睡眠症状的核心作用:日间嗜睡、失眠以及睡眠中的行为症状。对ICSD - 3结构进行这样的症状网络分析可为更好地系统化和组织睡眠医学中的症状学提供一个框架。

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