Aiming at the limitations of clinical diagnosis of Parkinson's disease (PD) with rapid eye movement sleep behavior disorder (RBD), in order to improve the accuracy of diagnosis, an intelligent-aided diagnosis method based on few-channel electroencephalogram (EEG) and time-frequency deep network is proposed for PD with RBD. Firstly, in order to improve the speed of the operation and robustness of the algorithm, the 6-channel scalp EEG of each subject were segmented with the same time-window. Secondly, the model of time-frequency deep network was constructed and trained with time-window EEG data to obtain the segmentation-based classification result. Finally, the output of time-frequency deep network was postprocessed to obtain the subject-based diagnosis result. Polysomnography (PSG) of 60 patients, including 30 idiopathic PD and 30 PD with RBD, were collected by Nanjing Brain Hospital Affiliated to Nanjing Medical University and the doctor's detection results of PSG were taken as the gold standard in our study. The accuracy of the segmentation-based classification was 0.902 4 in the validation set. The accuracy of the subject-based classification was 0.933 3 in the test set. Compared with the RBD screening questionnaire (RBDSQ), the novel approach has clinical application value.
Electroencephalography ; Humans ; Intelligence ; Parkinson Disease/diagnosis* ; Polysomnography ; REM Sleep Behavior Disorder/diagnosis*

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by sleep interruption or trauma due to abnormal behaviors that occur during REM sleep. The pathophysiology of RBD is known to be a dysfunction of brainstem circuit that causes the loss of skeletal muscle atonia during REM sleep. The diagnosis of RBD is needed to confirm REM sleep without atonia in the polysomnography. The management of RBD includes not only drug treatment, but also to prevent injury from RBD and to follow-up on neurodegenerative diseases that may occur later. RBD is thought to be a prodromal stage of neurodegenerative disease associated with α-synucleoinopathy, such as Parkinson's Disease or multiple system atrophy. This article reviews the symptoms, epidemiology, diagnosis and treatment of RBD, the relevance of neurodegenerative diseases, and recent research trends.
Brain Stem ; Diagnosis ; Epidemiology ; Follow-Up Studies ; Multiple System Atrophy ; Muscle, Skeletal ; Neurodegenerative Diseases ; Parasomnias ; Parkinson Disease ; Polysomnography ; Prodromal Symptoms ; REM Sleep Behavior Disorder ; Sleep, REM

OBJECTIVETo analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD).

METHODSFifty patients with iRBD and fifty controls were assessed with polysomnography (PSG). The results of olfactory function T & T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI) were compared. SPSS 11.0 software was used to analyze the data.

RESULTST & T olfactory testing revealed that iRBD patients had higher scores (3.1 ± 0.5) than those in controls (0.6 ± 0.1), and the difference was significant (t = 7.913, P < 0.05). Both men and women with iRBD were affected by the same extent of olfactory loss (t = 1.015, P > 0.05). OB volume of left side in iRBD patients was (33.75 ± 4.11) mm(3), right side was (34.57 ± 4.21) mm(3), average OB volume was (33.94 ± 4.15) mm(3); OB volume of left side in controls was (51.68 ± 7.71) mm(3), right side was (52.31 ± 7.77) mm(3), average OB volume was (51.94 ± 7.74) mm(3); OB volume were lower in iRBD patients as compared to controls (t value were 9.013, 8.889 and 8.923, all P < 0.01). OS depth study revealed no statistical difference between iRBD patients and controls (t value were 0.923, 0.897 and 0.904, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in iRBD patients (r = -0.61, P < 0.05), but no correlated with depth of OS (r = -0.24, P > 0.05).

CONCLUSIONSThe OB volume was lower in iRBD patients as compared to controls. The depth of OS showed no significant changes in iRBD patients. The OB volume was correlated with olfactory function, while the depth of OS was no correlated with olfactory function.

Female ; Humans ; Magnetic Resonance Imaging ; Male ; Olfaction Disorders ; complications ; diagnosis ; epidemiology ; Olfactory Bulb ; Polysomnography ; REM Sleep Behavior Disorder ; complications ; diagnosis ; epidemiology ; Smell

Dementia with Lewy bodies (DLB) is the second most common causes of dementia. It can exhibit a variety of clinical symptoms including cognitive decline, cognitive fluctuation, visual hallucinations, parkinsonism, REM sleep behavior disorder, hypersensitivity to neuroleptics and autonomic dysfunctions. Despite more well-known criteria for DLB, there are often misdiagnosis and inappropriate treatment. It gives a lot of clinical burden to the clinician as well as to patients and families. When reducing the misdiagnosis, the burden of all will be reduced. The special concern and solicitation are needed in order not to miss the diagnosis when the cardinal features of DLB may not be volunteered by patients and the caregivers. To control the symptoms, clinicians must find and reduce drugs that can have the negative effects on DLB symptoms. There is limited evidence about specific interventions but available data suggest cholinesterase inhibitors improve the cognitive and behavioral symptoms and menmantine slightly improves the global impression.
Antipsychotic Agents ; Behavioral Symptoms ; Caregivers ; Cholinesterase Inhibitors ; Dementia* ; Diagnosis ; Diagnostic Errors ; Hallucinations ; Humans ; Hypersensitivity ; Lewy Bodies* ; Parkinsonian Disorders ; REM Sleep Behavior Disorder

Distinguishing epileptic seizure from non-epileptic seizure is a common diagnostic problem. Neurogenic or cardiac syncope can appear similar to atonic and even convulsive seizures. Classic migraine and transient ischemic attacks may also resemble epileptic seizures. Sleep disorders including REM sleep behavior disorder, nocturnal paroxysmal dystonia, and narcolepsy likewise simulate an epileptic seizure. Movement disorders such as paroxysmal dyskinesia can be misinterpreted as epileptic seizures (reflex epilepsy or myoclonic seizures). Psychogenic seizures are often misdiagnosed as an intractable epilepsy. Prior to the definitive diagnosis of epilepsy, possible non-epileptic seizures should be excluded. For the correct decision, a thorough and systematic history taking is important. In addition, EEG, pseudoseizure induction test, head-up tilt test, EKG, sleep studies, and video-EEG monitoring may be necessary. Misdiagnosis of non-epileptic seizures as epilepsy may result in unnecessary anti-epileptic drug use. At the same time, we should let the patients understand what the epilepsy is and that epilepsy is a treatable disease.
Chorea ; Diagnosis ; Diagnostic Errors ; Drug Resistant Epilepsy ; Electrocardiography ; Electroencephalography ; Epilepsy* ; Humans ; Ischemic Attack, Transient ; Linear Energy Transfer ; Migraine with Aura ; Movement Disorders ; Narcolepsy ; Nocturnal Paroxysmal Dystonia ; REM Sleep Behavior Disorder ; Seizures* ; Sleep Wake Disorders ; Syncope