5/17/2023 0 Comments Istat 2016Patients considered as pRBD at second stage were invited to undergo a VPSG to confirm the presence of RBD (Stage III). The second stage allowed us to reach the diagnosis of isolated pRBD. Subjects with a suspected cognitive impairment underwent an extensive neuropsychological evaluation. 11 To exclude patients with dementia at this stage, cognition and activities of daily living were assessed with the Unified Parkinson’s Disease Rating Scale sections I and II. For all the enrolled patients at Stage II, the presence of extrapyramidal symptoms has been evaluated using the Unified Parkinson’s Disease Rating Scale III. When available, bed partners were contacted to provide information on the sleep behaviors. A board-certified sleep specialist (LG) and a movement disorders expert (CEC) confirmed the presence of pRBD, based on a standardized semistructured interview to exclude other sleep disorders and to evaluate the presence of other neurological disorders, including parkinsonisms. When the suspicion was confirmed, patients were invited to undergo a clinical evaluation at the neurology clinic of the AOU Policlinico–Vittorio Emanuele of Catania. The RBD Single Question Screen is a screening questionnaire with 94% sensitivity and 87% specificity validated in Italian language 10 and consists of the following question: “Have you ever been told, or suspected yourself, that you seem to ‘act out your dreams’ while asleep (for example, punching, flailing your arms in the air, making running movements, etc.)?”Īt the second stage (Stage II), participants positive at the screening phase underwent a structured phone interview carried out by a board-certified sleep specialist (LG) to confirm the suspicion of isolated RBD. Participants aged 40 years and above attended by the GPs were interviewed face-to-face by the students who administered the RBD Single Question Screen questionnaire. Seven trained medical students visited each of the GPs’ offices at least 3 times a week. GPs were given posters to be displayed in their waiting rooms explaining what is RBD. Before conducting the survey, several meetings were carried out with the selected GPs to explain the aim of the survey. The study has been conducted in the municipality of Catania, Italy (population: 314,555 inhabitants Istituto Nazionale di Statistica, ISTAT 2016) from April 2016 to November 2017.įor the first stage (screening phase–Stage I) a sample of general practitioners (GPs) working in the study area was randomly selected from the provincial roster of the Italian Society of General Medicine to participate in the study. 7, 9Īim of the current study is to assess the prevalence of both probable and definite isolated RBD in the city of Catania using a population-based 3-stage design. 8 In Italy, only 2 studies have been conducted on the prevalence of pRBD. 6, 7Īccording to a recent a recent meta-analysis, to date 5 studies have evaluated the prevalence of isolated definite RBD (dRBD) (confirmed by VPSG), resulting in a pooled prevalence of dRBD of 0.68% (95% confidence interval, 0.38–1.05) while the pooled prevalence of probable RBD (pRBD, not confirmed by VPSG), based on 14 studies, was 5.65% (95% CI, 4.29–7.18). Nonetheless, data about prevalence of isolated RBD are scarce, with few population-based studies often reporting estimates that differ significantly depending on the diagnostic process employed. 5 For this reason, it is of paramount importance to study the prevalence of the disease in the general population. 3 Indeed, it represents the most specific risk factor for the development of PD being the strongest prodromal marker in the diagnosis of “Prodromal PD” 4 and is part of the core criteria for the dementia with Lewy bodies diagnosis. Isolated RBD could be considered as an alpha-synucleinopathy in its earliest stages, conferring a high risk to convert to either Parkinson disease (PD), dementia with Lewy bodies, or multiple system atrophy. 1 Definite diagnosis can be made only with a video polysomnographic recording (VPSG) showing the lack of atonia during rapid eye movement sleep and the presence of abnormal behaviors, according to the current diagnostic criteria. Rapid eye movement (REM) sleep behavior disorder (RBD) is a condition characterized by the presence of abnormal behaviors in the sleep phase, such as sudden movements and vocalizations caused by a dream enactment behavior.
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