Questionnaire-based diagnosis of REM sleep behavior disorder in Parkinson's disease

Authors

  • Lama M. Chahine MD,

    Corresponding author
    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Division of Sleep Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Joseph Daley MD, PhD,

    1. Division of Sleep Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Stacy Horn DO,

    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Amy Colcher MD,

    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Howard Hurtig MD,

    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Charles Cantor MD,

    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Division of Sleep Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Nabila Dahodwala MD, MSCE

    1. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Funding agencies: This work was made possible through a generous philanthropic donation from the Vandrevala family.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the Acknowledgments section online.

ABSTRACT

Background

Rapid eye movement (REM) sleep behavior disorder (RBD) is present in around 40% of Parkinson's disease (PD) patients. Definitive diagnosis requires a polysomnogram, but that is costly, time intensive, and not practical for large-scale studies. Therefore, we assessed using a questionnaire-based diagnostic approach.

Methods

The patient-administered RBD questionnaire and bed-partner-administered question 1 of the Mayo questionnaire were prospectively validated.

Results

Seventy-five PD patients (51 male, 68 Hoehn and Yahr stages I and II) participated. Forty-eight had a clinical history of RBD. Sensitivity was 100% (95% CI, 86.3%–100%) when a combination of both questionnaires was compared with the gold standard of polysomnogram-confirmed RBD. Among those who achieved REM sleep (n = 65), specificity was highest for the patient questionnaire used alone, at 82.4% (95% CI, 64.8%–92.6%).

Conclusions

A combination of patient and bed-partner questionnaires is a useful tool to detect RBD. © 2013 Movement Disorder Society

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