Yaping Liu1, Jihui Zhang2, Siu Ping Lam1, Mandy Wai Man Yu1, Shirley Xin Li3, Junying Zhou4, Ngan Yin Chan5, Jing Wang1, Hongliang Feng1, Anne Chan6, Vincent Mok6, Yun Kwok Wing1. 1. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China. 2. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China. Electronic address: jihui.zhang@cuhk.edu.hk. 3. Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China. 4. Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. 5. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China; Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong, China. 6. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Abstract
OBJECTIVES: To investigate whether baseline electromyography (EMG) activity during rapid eye movement (REM) sleep predicts the development of neurodegenerative diseases over time in patients with idiopathic REM sleep behavior disorder (iRBD). METHODS: A total of 216 patients with polysomnography-confirmed iRBD were recruited from September 1997 to December 2016 with a mean follow-up duration of 5.0 ± 3.7 years (median: 4.0, range: 0.5-19.0). Neurodegenerative diseases were ascertained according to standard diagnostic criteria during follow-up. Time-dependent receiver operating characteristic (ROC) curves were employed to evaluate the dynamic predictive performance of EMG activity over time. Both tonic and phasic EMG activity were dichotomized into 'mild' and 'severe' categories by the ROC curves estimated optimal cut-offs. RESULTS: A total of 58 patients (26.9%) developed neurodegenerative diseases. The predictive performance of tonic EMG activity was stable (area under the curve of approximately 0.68) over time, while the performance of phasic EMG activity was significantly superior to chance only after five years of follow-up. The optimal cut-off for prediction at five years was 15.4% (sensitivity, 0.69; specificity, 0.57) and 7.8% (sensitivity, 0.79; specificity, 0.47) for tonic and phasic EMG activity, respectively. Cox proportional hazards regression analyses further revealed that severe tonic (adjusted HR: 2.76, 95% CI: 1.35-5.62) and phasic EMG activity (adjusted HR: 3.10, 95% CI: 1.10-8.71) were associated with early development of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), respectively. CONCLUSIONS: Tonic but not phasic EMG activity may serve as a stable biomarkers for predicting the progression of neurodegeneration in iRBD.
OBJECTIVES: To investigate whether baseline electromyography (EMG) activity during rapid eye movement (REM) sleep predicts the development of neurodegenerative diseases over time in patients with idiopathic REM sleep behavior disorder (iRBD). METHODS: A total of 216 patients with polysomnography-confirmed iRBD were recruited from September 1997 to December 2016 with a mean follow-up duration of 5.0 ± 3.7 years (median: 4.0, range: 0.5-19.0). Neurodegenerative diseases were ascertained according to standard diagnostic criteria during follow-up. Time-dependent receiver operating characteristic (ROC) curves were employed to evaluate the dynamic predictive performance of EMG activity over time. Both tonic and phasic EMG activity were dichotomized into 'mild' and 'severe' categories by the ROC curves estimated optimal cut-offs. RESULTS: A total of 58 patients (26.9%) developed neurodegenerative diseases. The predictive performance of tonic EMG activity was stable (area under the curve of approximately 0.68) over time, while the performance of phasic EMG activity was significantly superior to chance only after five years of follow-up. The optimal cut-off for prediction at five years was 15.4% (sensitivity, 0.69; specificity, 0.57) and 7.8% (sensitivity, 0.79; specificity, 0.47) for tonic and phasic EMG activity, respectively. Cox proportional hazards regression analyses further revealed that severe tonic (adjusted HR: 2.76, 95% CI: 1.35-5.62) and phasic EMG activity (adjusted HR: 3.10, 95% CI: 1.10-8.71) were associated with early development of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), respectively. CONCLUSIONS: Tonic but not phasic EMG activity may serve as a stable biomarkers for predicting the progression of neurodegeneration in iRBD.
Authors: Li Zhou; Steven W H Chau; Yaping Liu; Jing Wang; Jihui Zhang; Ngan Yin Chan; Joey W Y Chan; Bei Huang; Sijing Chen; Shirley Xin Li; Vincent Chung Tong Mok; Yun Kwok Wing Journal: NPJ Parkinsons Dis Date: 2022-07-14
Authors: Jeong Hun Yang; Sang Ho Choi; Mi Hyun Lee; Seong Min Oh; Jae-Won Choi; Jee Eun Park; Kwang Suk Park; Yu Jin Lee Journal: J Clin Sleep Med Date: 2021-03-01 Impact factor: 4.062
Authors: Petr Dušek; Veronika Lorenzo Y Losada Ibarburu; Ondrej Bezdicek; Irene Dall'antonia; Simona Dostálová; Petra Kovalská; Radim Krupička; Jiří Nepožitek; Tomáš Nikolai; Michal Novotný; Pavla Peřinová; Jan Rusz; Tereza Serranová; Tereza Tykalová; Olga Ulmanová; Zuzana Mecková; Václav Ptáčník; Jiří Trnka; David Zogala; Evžen Růžička; Karel Šonka Journal: Sci Rep Date: 2019-10-29 Impact factor: 4.379