RBD is a parasomnia that can develop in otherwise neurologically-normal adults as well as in those with a neurodegenerative disease. Confirmation of RBD requires PSG. A simple screening measure for RBD is desirable for clinical and research purposes. Boeve et al.
developed the Mayo Sleep Questionnaire (MSQ), a 16-item measure to screen for the presence of RBD, periodic legs movement disorder (PLMD), restless legs syndrome (RLS), sleepwalking, OSAS and sleep-related leg cramps (Boeve, 2010a; Boeve et al., 2002a, 2002b, 2010b, 2011). The data presented herein refer to the primary question on RBD (Question 1); if the primary question is answered affirmatively, subquestions are asked (subquestions 1b-e) as shown in Table 4.
1. 11-' e you ever seen tlie patient appeal to "act out his/her dreams*while sleeping?
(punched or flailed arms ill the air, shouted or screamed}. If yes,
(a) How can" months or years has this been going on? (data on this subquestion were not analyzed in this analysis)
(b) Has the patient ever been indued from these behaviors (bruises, cuts, broken holies)?
(c) Has a bed partner ever been injured from these behaviors (bruises, blows, pulled hail}?
(d) Has the patient told you about dreams of being chased, attacked or that involve defending himself /herself?
(e) If the patient woke up and told you about a dieam, did the details of the dieam match the movements made while sleeping?
Table 4. Primary question on RBD in the Mayo Sleep Questionnaire (MSQ) (from the website: http://www.mayoclinic.org/pdfs/MSQ-copyrightfinal.pdf.)
Among the community-dwelling elderly, the MSQ has high sensitivity (100%) and specificity (95%) for diagnosis of RBD and was particularly specific for RBD in the absence of an OSA feature (Boeve, 2010b).
Boeve et al. also assessed the validity of the MSQ by comparing the responses of patients' bed partners with the findings (REM sleep without atonia) on PSG. The study subjects were 176 individuals (150 males; median age 71 years (range 39-90)) with the following clinical diagnoses: normal (n=8), mild cognitive impairment (n=44), Alzheimer's disease (n=23), dementia with Lewy bodies (n=74), and other dementia and/or parkinsonian syndromes (n=27). Sensitivity and specificity for question 1 on the MSQ for PSG-proven RBD were 98% and 74%, respectively. They concluded that the MSQ has adequate sensitivity and specificity for the diagnosis of RBD among aged subjects with cognitive impairment and/or parkinsonism (Boeve et al, 2011).
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