Diagnostic criteria for disorders of arousal: A video-polysomnographic assessment
Autor: | Yun Shen, Lucie Barateau, Elisa Evangelista, Anna Laura Rassu, Isabelle Jaussent, Sofiene Chenini, Yves Dauvilliers, Régis Lopez |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Receiver operating characteristic medicine.diagnostic_test business.industry Area under the curve Somnambulism Polysomnography Audiology medicine.disease Arousal 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Neurology Sleepwalking Medicine Cutoff Neurology (clinical) business 030217 neurology & neurosurgery Slow-wave sleep |
Zdroj: | Annals of Neurology. 83:341-351 |
ISSN: | 0364-5134 |
Popis: | Objective To assess video-polysomnographic (vPSG) criteria and their cutoff values for the diagnosis of disorders of arousal (DOAs; sleepwalking, sleep terror). Methods One hundred sixty adult patients with DOAs and 50 sex- and age-matched healthy participants underwent a clinical evaluation and vPSG assessment to quantify slow wave sleep (SWS) interruptions (SWS fragmentation index, slow/mixed and fast arousal ratios, and indexes per hour) and the associated behaviors. First, a case-control analysis was performed in 100 patients and the 50 controls to define the optimal cutoff values using receiver operating characteristic curves. Their sensitivity was then assessed in the other 60 patients with DOAs. Results The SWS fragmentation index and the mixed, slow, and slow/mixed arousal indexes and ratios were higher in patients with DOAs than controls. The highest area under the curve (AUC) values were obtained for the SWS fragmentation and slow/mixed arousal indexes (AUC = 0.88 and 0.90, respectively). The SWS fragmentation index cutoff value of 6.8/h reached a sensitivity of 79% and a specificity of 82%. The slow/mixed arousal index had a sensitivity of 94% for the 2.5/h cutoff, and 100% specificity for 6/h. Both parameters showed good interrater agreement, and their sensitivities were confirmed in the second group of patients. Combining electroencephalographic parameters and video-based behavioral analyses increased the correct classification rate up to 91.3%. Interpretation Frequent slow/mixed arousals in SWS and complex behaviors during vPSG are strongly associated with DOAs, and could be promising biomarkers for the diagnosis of non-rapid eye movement parasomnias. Ann Neurol 2018;83:341-351. |
Databáze: | OpenAIRE |
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