Tuesday, 30 December 2014

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

Back-tracking perhaps... my impression is it is sensitive (particularly if one doesn't sleep alone) but there are a high number of false positives (i.e. low specificity)...

Sleep Med. 2014 Nov 13. pii: S1389-9457(14)00442-0. doi: 10.1016/j.sleep.2014.08.014. [Epub ahead of print]

Stiasny-Kolster K, Sixel-Döring F, Trenkwalder C, Heinzel-Gutenbrunner M, Seppi K, Poewe W, Högl B, Frauscher B.

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.

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