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Link to original content: https://pubmed.ncbi.nlm.nih.gov/24708629
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Clinical Trial
. 2014 Apr 6:14:76.
doi: 10.1186/1471-2377-14-76.

Actigraphy as a diagnostic aid for REM sleep behavior disorder in Parkinson's disease

Maartje Louter, Johan B A M Arends, Bastiaan R Bloem, Sebastiaan Overeem  1
Affiliations
Clinical Trial

Actigraphy as a diagnostic aid for REM sleep behavior disorder in Parkinson's disease

Maartje Louter et al. BMC Neurol. .

Abstract

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is a common parasomnia in Parkinson's disease (PD) patients. The current International Classification of Sleep Disorders (ICSD-II) requires a clinical interview combined with video polysomnography (video-PSG) to diagnose. The latter is time consuming and expensive and not always feasible in clinical practice. Here we studied the use of actigraphy as a diagnostic tool for RBD in PD patients.

Methods: We studied 45 consecutive PD patients (66.7% men) with and without complaints of RBD. All patients underwent one night of video-PSG and eight consecutive nights of actigraphy. Based on previous studies, the main outcome measure was the total number of bouts classified as "wake", compared between patients with (PD + RBD) and without RBD (PD- RBD).

Results: 23 (51.1%) patients had RBD according to the ICSD-II criteria. The total number of wake bouts was significantly higher in RBD patients (PD + RBD 73.2 ± 40.2 vs. PD-RBD 48.4 ± 23.3, p = .016). A cut off of 95 wake bouts per night resulted in a specificity of 95.5%, a sensitivity of 20.1% and a positive predictive value of 85.7%. Seven patients were suspected of RBD based on the interview alone, but not confirmed on PSG; six of whom scored below 95 wake bouts per night on actigraphy.

Conclusion: PD patients with RBD showed a significantly higher number of bouts scored as "wake" using actigraphy, compared to patients without RBD. In clinical practice, actigraphy has a high specificity, but low sensitivity in the diagnosis of RBD. The combination of actigraphy and previously reported RBD questionnaires may be a promising method to diagnose RBD in patients with PD.

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Figures

Figure 1
Figure 1
Distribution of wake bouts across groups. Boxplot of number of wake bouts per night measured over 8 nights in PD with without and with RBD.
Figure 2
Figure 2
ROC curve using number of wake bouts in diagnosis of RBD. Area under the curve (AUC) = 0.696.
Figure 3
Figure 3
Predictive value of actigraphy for RBD in PD, in relation to RBD prevalence.
See this image and copyright information in PMC

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