Validation of the Beijing Version of the REM Sleep Behavior Disorder Questionnaire (RBDQ-Beijing) in a Mainland Chinese Cohort

Validation of the Beijing Version of the REM Sleep Behavior Disorder Questionnaire (RBDQ-Beijing) in a Mainland Chinese Cohort

YI CHANG,¹ ZHUQIN GU,⁶ SHUQIN ZHAN,² HUI ZHANG,² YUAN LI,³ JING AN,³ YAN DING,² XIUHONG NIE¹ and PIU CHAN^2,3,4,5,6

¹Department of Respiratory Medicine, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
²Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
³Department of Neurobiology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
⁴Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, P.R. China
⁵Key Laboratory of Ministry of Education on Neurodegenerative Disorders and Beijing Key Laboratory on Parkinson's Disease, Beijing, P.R. China
⁶Chinese National Human Genome Center, Beijing, P.R. China

REM sleep behavior disorder (RBD) is one type of parasomnia characterized by nocturnal complex motor activity associated with dream mentation. Growing evidence has indicated that RBD is a preclinical stage of neurodegenerative diseases. Therefore screening RBD patient is becoming important. The RBD Questionnaire-Hong Kong (RBDQ-HK) is an effective questionnaire to screen RBD patients. However, it is hard to distinguish RBD with the questionnaire from severe OSAS patients, who could mimic some symptoms of RBD patients. Therefore, we made RBDQ-Beijing by adding two screening questions for OSAS into original RBDQ-HK, including habitual loud snoring and witnessed apnea during sleep. To validate and compare these two questionnaires, 224 subjects were enrolled and screened with these questionnaires, and consequently analyzed with video-polysomnography. Receiver-operator characteristics curve analysis was conducted to attain the best cut-off values of the RBDQ-HK and RBDQ-Beijing. For the RBDQ-HK, the sensitivity was 97.1% and the specificity was 83.2%. More than half of misclassified RBD patients were proved to be severe OSAS patients. For the RBDQ-Beijing, the sensitivity was 95.8% and specificity was 94.3%, indicating that our questionnaire is able to distinguish RBD from severe OSAS patients. In conclusion, RBDQ-Beijing is of help to improve the specificity in RBD screening without excluding the patients with RBD combined OSAS. Therefore the RBDQ-Beijing may be a better screening and preliminary diagnostic tool for RBD than the RBDQ-HK. Moreover, the RBDQ-Beijing would be important for early diagnosis of neurodegenerative diseases and for prevention of injuries to the patient or the patient's bed partner.

keywords —— neurodegenerative disease; obstructive sleep apnea syndrome; questionnaire; REM sleep behavior disorder; validity

===============================

Tohoku J. Exp. Med., 2014, 234, 7-15

Correspondence: Piu Chan, M.D., Ph.D., Department of Neurology and Neurobiology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, P.R.China.

e-mail: pbchan_xw@hotmail.com or pbchan90@gmail.com