Abstract Details

Title Questionnaire-Based Diagnosis of REM Sleep Behavior Disorder in Parkinson's Disease

Topic Movement Disorders

Presentation(s) S03 - (-)

Poster/Presentation
Number 004

Objective

Background RBD is present in up to 40% of PD patients and may portend more severe PD manifestations. It can also pose increased risk of injury, but is treatable. Definitive diagnosis of RBD requires demonstration of REM sleep without atonia on polysomnogram, but this is costly, time-intensive, and not practical for large-scale studies.

Design/Methods We prospectively validated the patient-administered REM sleep behavior disorder questionnaire (RBSQ) and bed-partner-administered question 1 of the Mayo questionnaire in a convenience sample of 75 PD patients. A diagnosis of RBD was made based on International Classification of Sleep Disorders-II criteria: polysomnographic evidence of REM sleep without atonia and a clinical history of dream enactment behavior, determined through interview with the patient and his/her bed-partner.

Results 75 PD patients (51 male, 68 Hoehn and Yahr stage I and II) participated. 48 had a clinical history of RBD. A cut-off on the RBSQ of 6 classified 70% of those with RBD correctly. Among those who achieved REM sleep (n=65), sensitivity was 74.2%(95% CI 55.1-87.5) for the RBSQ alone but was 100% [95% CI 86.3-100] when a combination of both questionnaires was compared to the gold standard of polysomnogram-confirmed RBD. Specificity was highest at 85.3% [95% CI 68.1-94.4] for the RBSQ used alone.

Conclusions A combination of patient and bed-partner questionnaires is a useful tool to detect RBD in PD. Questionnaire-based diagnosis is more practical than diagnostic criteria that require polysomnographic confirmation. Combined use of patient and bed-partner questionnaire to diagnose RBD in the PD population would be an ideal screen. It is hoped that accurate questionnaire-based diagnosis will facilitate large-scale cohort studies to better understand the implications of RBD in PD.

Authors/Disclosures
Lana Chahine, MD, FAAN PRESENTER	Dr. Chahine has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gray Matters Technology. The institution of Dr. Chahine has received research support from UPMC. The institution of Dr. Chahine has received research support from MJFF. The institution of Dr. Chahine has received research support from Denali/Biogen. Dr. Chahine has received publishing royalties from a publication relating to health care.
Joseph Daley, MD, PhD	No disclosure on file
Stacy H. Ahmad, DO	No disclosure on file
Amy Colcher, MD (Cooper Neurological Institute)	No disclosure on file
Howard I. Hurtig, MD (University of Pennsylvania)	No disclosure on file
	No disclosure on file
Charles R. Cantor, MD	No disclosure on file
Nabila Dahodwala, MD, FAAN (Parkinson's disease and Movement Disorders Center)	Dr. Dahodwala has received personal compensation in the range of $0-$499 for serving as a Consultant for Genetech. Dr. Dahodwala has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mediflix. Dr. Dahodwala has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Dahodwala has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Post and Schell. Dr. Dahodwala has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for O'Brien & Ryan, LLP. The institution of Dr. Dahodwala has received research support from AbbVie. The institution of Dr. Dahodwala has received research support from Medtronic.

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