Polysomnographic diagnosis of idiopathic REM sleep behavior disorder
Identifieur interne : 000436 ( Istex/Corpus ); précédent : 000435; suivant : 000437Polysomnographic diagnosis of idiopathic REM sleep behavior disorder
Auteurs : Jacques Montplaisir ; Jean-Francois Gagnon ; Maria Livia Fantini ; Ronald B. Postuma ; Yves Dauvilliers ; Alex Desautels ; Sylvie Rompré ; Jean PaquetSource :
- Movement Disorders [ 0885-3185 ] ; 2010-10-15.
English descriptors
Abstract
The presence of either excessive tonic chin EMG activity during REM sleep, or excessive phasic submental or limb EMG twitching is required to diagnose REM sleep behavior disorder (RBD). The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. For the five RBD patients who did not show chin EMG abnormalities, it cannot be excluded that they had increased phasic EMG activity in the upper limbs and presented visible motor activity. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23257
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ISTEX:E3A23C712D2D1736F417210004D089C7468E32B9Le document en format XML
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The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. For the five RBD patients who did not show chin EMG abnormalities, it cannot be excluded that they had increased phasic EMG activity in the upper limbs and presented visible motor activity. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Jacques Montplaisir MD, PhD</name><affiliations><json:string>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>Jean‐Francois Gagnon PhD</name><affiliations><json:string>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>Maria Livia Fantini MD, MSc</name><affiliations><json:string>Sleep Disorders Center, Department of Neurology, Università Vita‐Salute San Raffaele, Milan, Italy</json:string></affiliations></json:item><json:item><name>Ronald B. Postuma MD</name><affiliations><json:string>Department of Neurology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada</json:string></affiliations></json:item><json:item><name>Yves Dauvilliers MD, PhD</name><affiliations><json:string>Department of Neurology, Hôpital Gui de Chauliac, Inserm, U888, Université de Montpellier, Montpellier, France</json:string></affiliations></json:item><json:item><name>Alex Desautels MD, PhD</name><affiliations><json:string>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>Sylvie Rompré PSGT</name><affiliations><json:string>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</json:string></affiliations></json:item><json:item><name>Jean Paquet PhD</name><affiliations><json:string>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</json:string><json:string>Department of Psychiatry, Université de Montréal, Québec, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>RBD</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>REM sleep</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>EMG</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>scoring</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diagnosis</value></json:item></subject><language><json:string>eng</json:string></language><abstract>The presence of either excessive tonic chin EMG activity during REM sleep, or excessive phasic submental or limb EMG twitching is required to diagnose REM sleep behavior disorder (RBD). The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. 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Gouin Ouest, Montréal, Québec, Canada, H4J 1C5</p></note><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation></author><author><persName><forename type="first">Jean‐Francois</forename><surname>Gagnon</surname><roleName type="degree">PhD</roleName></persName><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation></author><author><persName><forename type="first">Maria Livia</forename><surname>Fantini</surname><roleName type="degree">MD, MSc</roleName></persName><affiliation>Sleep Disorders Center, Department of Neurology, Università Vita‐Salute San Raffaele, Milan, Italy</affiliation></author><author><persName><forename type="first">Ronald B.</forename><surname>Postuma</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada</affiliation></author><author><persName><forename type="first">Yves</forename><surname>Dauvilliers</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Department of Neurology, Hôpital Gui de Chauliac, Inserm, U888, Université de Montpellier, Montpellier, France</affiliation></author><author><persName><forename type="first">Alex</forename><surname>Desautels</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation></author><author><persName><forename type="first">Sylvie</forename><surname>Rompré</surname><roleName type="degree">PSGT</roleName></persName><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation></author><author><persName><forename type="first">Jean</forename><surname>Paquet</surname><roleName type="degree">PhD</roleName></persName><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-10-15"></date><biblScope unit="vol">25</biblScope><biblScope unit="issue">13</biblScope><biblScope unit="page" from="2044">2044</biblScope><biblScope unit="page" to="2051">2051</biblScope></imprint></monogr><idno type="istex">E3A23C712D2D1736F417210004D089C7468E32B9</idno><idno type="DOI">10.1002/mds.23257</idno><idno type="ArticleID">MDS23257</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The presence of either excessive tonic chin EMG activity during REM sleep, or excessive phasic submental or limb EMG twitching is required to diagnose REM sleep behavior disorder (RBD). The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. For the five RBD patients who did not show chin EMG abnormalities, it cannot be excluded that they had increased phasic EMG activity in the upper limbs and presented visible motor activity. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>RBD</term></item><item><term>REM sleep</term></item><item><term>EMG</term></item><item><term>scoring</term></item><item><term>diagnosis</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-08-27">Received</change><change when="2010-04-25">Registration</change><change when="2010-10-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/E3A23C712D2D1736F417210004D089C7468E32B9/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="130"><doi origin="wiley" registered="yes">10.1002/mds.v25:13</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">13</numbering></numberingGroup><coverDate startDate="2010-10-15">15 October 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="60" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23257</doi><idGroup><id type="unit" value="MDS23257"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-08-27"></event><event type="manuscriptRevised" date="2009-12-17"></event><event type="manuscriptAccepted" date="2010-04-25"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.5.2 mode:FullText source:FullText result:FullText" date="2011-07-06"></event><event type="publishedOnlineEarlyUnpaginated" date="2010-09-03"></event><event type="publishedOnlineFinalForm" date="2010-10-07"></event><event type="firstOnline" date="2010-09-03"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">2044</numbering><numbering type="pageLast">2051</numbering></numberingGroup><correspondenceTo>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, 5400 boul. Gouin Ouest, Montréal, Québec, Canada, H4J 1C5</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23257.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="6"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="27"></count><count type="wordTotal" number="5769"></count></countGroup><titleGroup><title type="main" xml:lang="en">Polysomnographic diagnosis of idiopathic REM sleep behavior disorder<link href="#fn5"></link> <link href="#fn6"></link></title><title type="short" xml:lang="en">Diagnosis of Idiopathic REM Sleep Behavior</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Jacques</givenNames><familyName>Montplaisir</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>jy.montplaisir@umontreal.ca</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Jean‐Francois</givenNames><familyName>Gagnon</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Maria Livia</givenNames><familyName>Fantini</familyName><degrees>MD, MSc</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Ronald B.</givenNames><familyName>Postuma</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Yves</givenNames><familyName>Dauvilliers</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Alex</givenNames><familyName>Desautels</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Sylvie</givenNames><familyName>Rompré</familyName><degrees>PSGT</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Jean</givenNames><familyName>Paquet</familyName><degrees>PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="CA" type="organization"><unparsedAffiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="CA" type="organization"><unparsedAffiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="IT" type="organization"><unparsedAffiliation>Sleep Disorders Center, Department of Neurology, Università Vita‐Salute San Raffaele, Milan, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="CA" type="organization"><unparsedAffiliation>Department of Neurology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurology, Hôpital Gui de Chauliac, Inserm, U888, Université de Montpellier, Montpellier, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">RBD</keyword><keyword xml:id="kwd2">REM sleep</keyword><keyword xml:id="kwd3">EMG</keyword><keyword xml:id="kwd4">scoring</keyword><keyword xml:id="kwd5">diagnosis</keyword></keywordGroup><fundingInfo><fundingAgency>Canadian Institutes of Health Research</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The presence of either excessive tonic chin EMG activity during REM sleep, or excessive phasic submental or limb EMG twitching is required to diagnose REM sleep behavior disorder (RBD). The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. For the five RBD patients who did not show chin EMG abnormalities, it cannot be excluded that they had increased phasic EMG activity in the upper limbs and presented visible motor activity. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn5"><p>This is not an industry supported study.</p></note><note xml:id="fn6"><p>Potential conflict of interest: This research was supported by the Canadian Institutes of Health Research and by the Fonds de la recherche en santé du Québec.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Polysomnographic diagnosis of idiopathic REM sleep behavior disorder</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Diagnosis of Idiopathic REM Sleep Behavior</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Polysomnographic diagnosis of idiopathic REM sleep behavior disorder</title></titleInfo><name type="personal"><namePart type="given">Jacques</namePart><namePart type="family">Montplaisir</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><description>Correspondence: Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, 5400 boul. Gouin Ouest, Montréal, Québec, Canada, H4J 1C5</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean‐Francois</namePart><namePart type="family">Gagnon</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maria Livia</namePart><namePart type="family">Fantini</namePart><namePart type="termsOfAddress">MD, MSc</namePart><affiliation>Sleep Disorders Center, Department of Neurology, Università Vita‐Salute San Raffaele, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ronald B.</namePart><namePart type="family">Postuma</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yves</namePart><namePart type="family">Dauvilliers</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Hôpital Gui de Chauliac, Inserm, U888, Université de Montpellier, Montpellier, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alex</namePart><namePart type="family">Desautels</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sylvie</namePart><namePart type="family">Rompré</namePart><namePart type="termsOfAddress">PSGT</namePart><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean</namePart><namePart type="family">Paquet</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré‐Coeur de Montréal, Québec, Canada</affiliation><affiliation>Department of Psychiatry, Université de Montréal, Québec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-10-15</dateIssued><dateCaptured encoding="w3cdtf">2009-08-27</dateCaptured><dateValid encoding="w3cdtf">2010-04-25</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">6</extent><extent unit="tables">2</extent><extent unit="references">27</extent><extent unit="words">5769</extent></physicalDescription><abstract lang="en">The presence of either excessive tonic chin EMG activity during REM sleep, or excessive phasic submental or limb EMG twitching is required to diagnose REM sleep behavior disorder (RBD). The aim was to identify cut‐off values and to assess the sensitivity and specificity of these values taken separately or combined to diagnose idiopathic RBD patients. Eighty patients presenting with a clinical diagnosis of idiopathic RBD and 80 age‐ and gender‐matched normal controls were studied in the sleep laboratory. Receiver operating characteristic curves were drawn to find optimal cut‐off values for three REM sleep EMG parameters. Tonic and phasic EMG activity were measured in the chin, but not in the limbs. Videos were examined during the recording but were not systematically reviewed by the authors. Total correct classification of 81.9% was found for tonic chin EMG density ≥30%; 83.8% for phasic chin EMG density ≥15% and 75.6% for ≥24 leg movements per hour of REM sleep. Five patients did not fulfill any of these three polysomnographic (PSG) criteria. Conversely, one subject of the control group met the PSG criteria for RBD. This study estimates the diagnostic value of a visual scoring method for the diagnosis of idiopathic RBD and establishes cut‐off values to be used in clinical and research set‐ups. For the five RBD patients who did not show chin EMG abnormalities, it cannot be excluded that they had increased phasic EMG activity in the upper limbs and presented visible motor activity. © 2010 Movement Disorder Society</abstract><note type="content">*This is not an industry supported study.</note><note type="content">*Potential conflict of interest: This research was supported by the Canadian Institutes of Health Research and by the Fonds de la recherche en santé du Québec.</note><note type="funding">Canadian Institutes of Health Research</note><subject lang="en"><genre>Keywords</genre><topic>RBD</topic><topic>REM sleep</topic><topic>EMG</topic><topic>scoring</topic><topic>diagnosis</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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