Screening Questionnaires And Clinical Features Study Of Rem Sleep Behavior Disorder

Part1 Application value of the screening questionnaires for REM sleep behavior disorderObjective: To estimate the application value and estimate the best cut-off values of REM Sleep Behavior Disorder Screening Questionnaire(RBDSQ)and REM Sleep Behavior Disorder Questionnaire-Hong Kong(RBDQ-HK)in our hospital.And to search for an effective way for the quick screening of REM sleep behavior disorder.Methods: Eight-seven patients(thirty-eight in RBD group and forty-nine in control group)recruited from the Department of Neurology and the Department of Respiration,Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine from Feb,2015 to Feb,2016 were selected.They all completed the RBDSQ and RBDQ-HK questionnaires before taking polysomnography(PSG)test.PSG results served as the criteria for final diagnosis.Results: The best cut-off value for RBDSQ was 5(AUC=0.918)with sensitivity 84.2%,specificity 87.8%,positive predictive value(PPV)82.1%,negative predictive value(NPV)87.5%.And the best cut-off value for RBDQ-HK was 20(AUC=0.935)with sensitivity 92.1%,specificity 81.6%,PPV 79.5%,NPV 93.0%.Conclusions: RBDSQ and RBDQ-HK demonstrated high sensitivities and specificities in the screening of RBD in our hospital,and could be used as useful tools for screening of RBD in the future.Part2 Clinical features of REM sleep behavior disorderObjective: To validate and analyze the clinical features of REM sleep behavior disorder and provide suggestions for clinical diagnosis and treatment.Methods: Thirty-nine patients(nineteen with RBD and twenty with other sleep disorders)diagnosed by PSG test were recruited from the Department of Neurology and the Department of Respiration,Ruijin Hospital Shanghai Jiaotong University School of Medicine from Aug,2015 to Feb,2016.Eight patients with mild cognitive impairment(MCI)and twenty-six health control were also added into our research.They all completed the record for basic information and the assessment of our scales.Results: All the groups were matched in sex and education level.People in other sleep disorders group showed a significant difference with health control group and MCI group.In cognitive function,RBD group showed difference in instant and long-term delayed memory with health control.And the visuospatial recalling ability of RBD group was not as good as the health control and other sleep disordered people.Simultaneously,MCI patients gave poorer performance than other three groups in all cognitive domains,including: memory,verbal frequency,attention,executive function and visuospatial and constructional ability.Moreover,RBD group has also demonstrated some impairments in olfactory,autonomic function and state of anxiety.Further comparison between i RBD and PD-RBD subgroups indicated a difference only in autonomic function among all the non-motor symptoms.Conclusions: RBD shows features of mild cognitive impairment,hyposmia,autonomic dysfunction and psychiatric dysfunction,the cognitive domains mainly affected are visuospatial and memory domains.