한국 렘수면행동장애 환자의 렘수면무긴장소실의 정량적 분석:도수적 방법과 컴퓨터 지원 방법과의 비교
Quantification of REM Sleep without Atonia in Korean REM Sleep Behavior Disorder Patients: Comparison of Manual and Computer-Assisted Scoring Methods
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Abstract
Objectives : The Polysomnographic(PSG) hallmark of REM sleep behavior disorder (RBD) is loss of muscle atonia during REM sleep; REM sleep without atonia (RSWA). However, the international classification of sleep disorders (ICSD) – 3 criteria did not suggest optimized diagnostic value of RSWA and how to score muscle activity during REM sleep. Many previous studies have been tried to figure out the objective quantitative cut- off values of RSWA. We investigated RSWA in Korean RBD patients compared with normal control, to figure out it’s cut-off value in diagnosis of RBD, using both manual and computer-assisted scoring methods (REM atonia index, RAI). Methods: We retrospectively analyzed PSG and clinical data of 40 patients, 10 age-matched controls by ICSD-3 criteria. The quantitative analysis of chin electromyography (EMG) density during REM sleep was done by both manual and computerized method. The RSWA and RAI were compared within two groups to figure out cut-off values for distinguishing two groups. Result: In computerized method, the mean RAI of RBD patient was 0.66 [±0.20, standard deviation (SD)], and 0.93 [±0.38, SD, p<0.001) in control group. Also, in manual method, RSWA were also significantly increased within RBD patient compared with normal controls. (tonic activity : 9.1±10.3 vs 0.1±0.2, phasic activity : 7.5±6.4 vs 1.6±1.2, p<0.002) Conclusion : We quantitatively figured out the characteristics of RSWA in Korean RBD patients and suggest that we may diagnose RBD who have RSWA more than 4.1% of total REM sleep duration and RAI lower than 0.84.
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