Automatic analysis of muscular activity in the flexor digitorum superficialis muscles: a fast screening method for rapid eye movement sleep without atonia.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: United States NLM ID: 7809084 Publication Model: Print Cited Medium: Internet ISSN: 1550-9109 (Electronic) Linking ISSN: 01618105 NLM ISO Abbreviation: Sleep Subsets: MEDLINE
    • Publication Information:
      Publication: 2017- : New York : Oxford University Press
      Original Publication: New York, Raven Press.
    • Subject Terms:
      Sleep, REM*/physiology ; REM Sleep Behavior Disorder*/diagnosis; Humans ; Electromyography/methods ; Muscle, Skeletal/physiology ; Muscle Hypotonia/diagnosis ; Facial Muscles
    • Abstract:
      Study Objectives: To identify a fast and reliable method for rapid eye movement (REM) sleep without atonia (RWA) quantification.
      Methods: We analyzed 36 video-polysomnographies (v-PSGs) of isolated REM sleep behavior disorder (iRBD) patients and 35 controls' v-PSGs. Patients diagnosed with RBD had: i) RWA, quantified with a reference method, i.e. automatic and artifact-corrected 3-s Sleep Innsbruck Barcelona (SINBAR) index in REM sleep periods (RSPs, i.e. manually selected portions of REM sleep); and ii) v-PSG-documented RBD behaviors. We quantified RWA with other (semi)-automated methods requiring less human intervention than the reference one: the indices proposed by the SINBAR group (the 3-s and 30-s phasic flexor digitorum superficialis (FDS), phasic/"any"/tonic mentalis), and the REM atonia, short and long muscle activity indices (in mentalis/submentalis/FDS muscles). They were calculated in whole REM sleep (i.e. REM sleep scored following international guidelines), in RSPs, with and without manual artifact correction. Area under curves (AUC) discriminating iRBD from controls were computed. Using published cut-offs, the indices' sensitivity and specificity for iRBD identification were calculated. Apnea-hypopnea index in REM sleep (AHIREM) was considered in the analyses.
      Results: RWA indices from FDS muscles alone had the highest AUCs and all of them had 100% sensitivity. Without manual RSP selection and artifact correction, the "30-s phasic FDS" and the "FDS long muscle activity" had the highest specificity (85%) with AHIREM < 15/h. RWA indices were less reliable when AHIREM≥15/h.
      Conclusions: If AHIREM<15/h, FDS muscular activity in whole REM sleep and without artifact correction is fast and reliable to rule out RWA.
      (© Sleep Research Society 2022. Published by Oxford University Press on behalf of the Sleep Research Society.)
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    • Contributed Indexing:
      Keywords: FDS; RBD; REM sleep without atonia; RWA; SINBAR; upper extremities
    • Publication Date:
      Date Created: 20220105 Date Completed: 20230310 Latest Revision: 20231209
    • Publication Date:
      20231215
    • Accession Number:
      PMC9995778
    • Accession Number:
      10.1093/sleep/zsab299
    • Accession Number:
      34984464