한빛사논문
- 조회326
Woo-Jin Lee1,2, Shin-Hye Baek3, Hee-Jin Im4, Seung-Ku Lee5, Jee-Eun Yoon6, Robert J Thomas7, Y. K. Wing8, Chol Shin5,9,a and Chang-Ho Yun, MD, PhD1,2,a
1Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
2Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
3Department of Neurology, Cheongju Saint Mary's Hospital, Cheongju, Republic of Korea
4Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
5Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
6Department of Neurology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
7Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
8Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
9Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
aCorresponding Author: Chang-Ho Yun, Chol Shin
Abstract
Objective: To evaluate the prevalence of REM sleep behavior disorder (RBD) and its possible prodromal conditions, isolated dream-enactment behavior (DEB) and isolated REM without atonia (RWA), in a general population sample, and the factors associated with diagnosis and symptom frequency.
Methods: From a population-based prospective cohort in Korea, 1,075 subjects (age 60.1±7.0 years; range 50-80 years; men 53.7%) completed the RBD screening questionnaire (RBDSQ), a structured telephone-interview for the presence and characteristics of repeated DEB, and home polysomnography. REM without atonia (RWA) was measured on submentalis EMG, including 30-second epoch based tonic and phasic activity as well as 3-second mini-epoch based phasic and any EMG activities. Based on the presence of repeated DEB and any EMG activity of ≥22.3%, we categorized the subjects into no RBD, isolated RWA, isolated DEB, and RBD groups.
Results: RBD was diagnosed in 20, isolated RWA in 133 subjects, and isolated DEB in 48 subjects. Sex and DEB frequency-adjusted prevalence of RBD was 1.4% (95% confidence interval [CI] 1.0-1.8%), isolated RWA 12.5% (95% CI 11.3-13.6%), and isolated DEB 3.4% (95% CI 2.7-4.1%). Total RBDSQ score was higher in the RBD and isolated DEB groups than in the isolated RWA and no RBD group (median 5, interquartile range [IQR 4-6] for RBD, median 4 [IQR 3-6] for isolated DEB, median 2 [IQR 1-3] for isolated RWA and median 2 [IQR 1-4] for no RBD groups, P<0.001). RBDSQ score of ≥5 had good specificity but poor positive predictive value (PPV) for RBD (specificity 84.1% and PPV 7.7%) and its prodromal conditions (specificity 85.2% and PPV 29.1%). Among the RWA parameters, any EMG activity showed the best association with the RBD and its possible prodromes (area under the curve, 0.917). 3-second mini-epoch based any EMG activity and phasic EMG activity were correlated with the frequency of DEB (standardized Jonckheere-Terpstra Statistic [std. J-T static] for trend =0.488, P<0.001 and std. J-T static=3.265, P=0.001, respectively).
Conclusions: This study provides prevalence estimates of RBD and its possible prodromal conditions based on a structured telephone-interview and RWA measurement on PSG from the general population.
논문정보
- Research article
- 2023년 10월 (BRIC 등록일 2023-10-18)
- 국내(교신)+국외 연구진
- 의약학 > 신경의학
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