The REM Sleep Behavior Disorder Screening Questionnaire is not Valid in De Novo Parkinson's Disease

Claire Halsband, Antonia Zapf, Friederike Sixel-Döring, Claudia Trenkwalder, Brit Mollenhauer, Claire Halsband, Antonia Zapf, Friederike Sixel-Döring, Claudia Trenkwalder, Brit Mollenhauer

Abstract

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is one of the most specific prodromal indicators for Parkinson's disease (PD).

Objectives: To test the validity of the RBD-Screening Questionnaire (RBDSQ) in assessing RBD in early PD.

Methods: The RBDSQ was completed before video-supported polysomnography (vPSG) by 134 de novo PD patients, 109 matched controls without neurological disorder (CTR) and 30 subjects with idiopathic RBD (iRBD) without clinical signs of PD; results were compared with vPSG-confirmed RBD diagnosis.

Results and conclusions: Sensitivity/specificity of the RBDSQ for the PD cohort were 0.44/0.84 at the previously published cut-off score of 6 for PD patients, and the area under the curve (AUC) 0.68 (95% CI, 0.56-0.79). By contrast, in the iRBD/CTR cohort the RBDSQ (cut-off = 5) had a sensitivity/specificity of 0.97/0.84 and an AUC of 0.95 (95% CI, 0.90-1.00). Subanalysis of question 6 only (4 subitems asking for dream enactment) at a cut-off score of 1 revealed a sensitivity of 0.74 and a specificity of 0.70 for the de novo PD cohort, AUC was 0.74 (95% CI, 0.63-0.84). RBDSQ is an insufficient screening tool for RBD in de novo PD. New screening tools for RBD assessment need to be developed.

Keywords: DeNoPa cohort, prodromal marker; Parkinson's disease; RBDSQ; REM sleep behavior disorder screening questionnaire.

Figures

Figure 1
Figure 1
(A) RBDSQ performance in a de novo PD cohort compared to idiopathic RBD patients/ controls; (B) Corresponding Receiver Operating Characteristic (ROC) curves; (C) RBDSQ subitems. Abbreviations: AUC, area under the curve; CI, confidence interval. *Indicated cut‐off not applicable

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Source: PubMed

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