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Automated Assessment of Quantitative REM Sleep without Atonia for Diagnosis of REM Sleep Behavior Disorder

Chronobiology in Medicine 2020년 2권 3호 p.123 ~ 128
양정훈, 최상호, 이미현, 오성민, 최재원, 박지은, 박광석, 이유진,
소속 상세정보
양정훈 ( Yang Jeong-Hun ) - Seoul National University Hospital Department of Psychiatry
최상호 ( Choi Sang-Ho ) - Seoul National University Interdisciplinary Program in Bioengineering
이미현 ( Lee Mi-Hyun ) - Seoul National University College of Medicine Seoul National University Hospital Department of Psychiatry
오성민 ( Oh Seong-Min ) - Dongguk University Ilsan Hospital Department of Psychiatry
최재원 ( Choi Jae-Won ) - Eulji University School of Medicine Department of Neuropsychiatry
박지은 ( Park Jee-Eun ) - Seoul National University College of Medicine Department of Psychiatry
박광석 ( Park Kwang-Suk ) - Seoul National University College of Medicine Department of Biomedical Engineering
이유진 ( Lee Yu-Jin ) - Seoul National University College of Medicine Department of Psychiatry

Abstract


Objective: This study was performed to determine the diagnostic cutoff value of quantified tonic and phasic rapid eye movement (REM) sleep without atonia (RSWA) automatically calculated from chin and limb muscle electromyograms (EMG) for diagnosis of REM sleep behavior disorder (RBD).

Methods: Nocturnal video polysomnographic data of 57 patients diagnosed with RBD and 29 age- and sex-matched controls were reviewed. Tonic activity was measured using submentalis EMG, and phasic activity was measured using submentalis and bilateral anterior tibialis EMG. The proportion of epochs with tonic and phasic activity during the entire REM sleep period was quantified using a self-developed automated algorithm.

Results: The RBD group showed significantly more tonic activity compared with the control group (28.87±36.92% vs. 12.94±31.69%, respectively, p<0.001). The diagnostic cutoff value of quantified submentalis tonic RSWA for RBD showing the best optimal sensitivity and specificity was 0.99% [sensitivity, 77.2%; specificity, 79.3%, area under the receiver operating characteristic curve (AUC), 0.76]. Cutoffs of phasic RSWA were 47.53% when assessed in the submentalis only (sensitivity, 1.8%; specificity, 100%; AUC, 0.46), 0.10% in the anterior tibialis (sensitivity, 66.7%; specificity, 55.2%; AUC, 0.55), and 0.10% in both the submentalis and anterior tibialis (sensitivity, 70.2%; specificity, 51.7%; AUC, 0.53).

Conclusion: This study provided evidence for the diagnosis of RBD using an automated method by assessing RSWA. Tonic activity in the submentalis muscle showed better sensitivity and specificity for diagnosis of RBD than did phasic activity.

키워드

REM sleep behavior disorder; REM sleep without atonia; Automated algorithm

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