Comparison of computerized methods for rapid eye movement sleep without atonia detection

Matteo Cesari*, Julie Anja Engelhard Christensen, Lykke Kempfner, Alexander Neergaard Olesen, Geert Mayer, Karl Kesper, Wolfgang H Oertel, Friederike Sixel-Döring, Claudia Trenkwalder, Helge Bjarup Dissing Sørensen, Poul Jennum

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Rapid eye movement (REM) sleep without atonia detection is a prerequisite for diagnosis of REM sleep behavior disorder (RBD). As the visual gold standard method is time-consuming and subjective, several automated methods have been proposed. This study aims to compare their performances: The REM atonia index (RAI), the supra-threshold-REM-activity metric, the Frandsen index, the short/long muscle activity indices, and the Kempfner index algorithms were applied to 27 healthy control participants (C), 25 patients with Parkinson’s disease (PD) without RBD (PD-RBD), 29 patients with PD and RBD (PD + RBD), 29 idiopathic patients with RBD, and 36 patients with periodic limb movement disorder (PLMD). The indices were calculated in various configurations: (1) considering all muscle activities; (2) excluding the ones related to arousals; (3) excluding the ones during apnea events; (4) excluding the ones before and after apnea events; (5) combining configurations 2 and 3; and (6) combining configurations 2 and 4. For each of these configurations, the discrimination capability of the indices was tested for the following comparisons: (1) (C, PD-RBD, PLMD) vs (PD + RBD, RBD); (2) C vs RBD; (3) PLMD vs RBD; (4) C vs PD-RBD; (5) C vs PLMD; (6) PD-RBD vs PD + RBD; and (7) C vs PLMD vs RBD. Results showed varying methods’ performances across the different configurations and comparisons, making it impossible to identify the optimal method and suggesting the need of further improvements. Nevertheless, RAI seems the most sensible one for RBD detection. Moreover, apnea and arousal-related movements seem not to influence the algorithms’ performances in patients’ classification.
Original languageEnglish
JournalSleep
Volume41
Issue number10
Number of pages11
ISSN0161-8105
DOIs
Publication statusPublished - 2018

Keywords

  • Automated method
  • Computerized analysis
  • Electromyography
  • Parkinson’s disease
  • Polysomnography
  • REM sleep behavior disorder
  • REM sleep without atonia

Cite this

Cesari, Matteo ; Christensen, Julie Anja Engelhard ; Kempfner, Lykke ; Olesen, Alexander Neergaard ; Mayer, Geert ; Kesper, Karl ; Oertel, Wolfgang H ; Sixel-Döring, Friederike ; Trenkwalder, Claudia ; Sørensen, Helge Bjarup Dissing ; Jennum, Poul. / Comparison of computerized methods for rapid eye movement sleep without atonia detection. In: Sleep. 2018 ; Vol. 41, No. 10.
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title = "Comparison of computerized methods for rapid eye movement sleep without atonia detection",
abstract = "Rapid eye movement (REM) sleep without atonia detection is a prerequisite for diagnosis of REM sleep behavior disorder (RBD). As the visual gold standard method is time-consuming and subjective, several automated methods have been proposed. This study aims to compare their performances: The REM atonia index (RAI), the supra-threshold-REM-activity metric, the Frandsen index, the short/long muscle activity indices, and the Kempfner index algorithms were applied to 27 healthy control participants (C), 25 patients with Parkinson’s disease (PD) without RBD (PD-RBD), 29 patients with PD and RBD (PD + RBD), 29 idiopathic patients with RBD, and 36 patients with periodic limb movement disorder (PLMD). The indices were calculated in various configurations: (1) considering all muscle activities; (2) excluding the ones related to arousals; (3) excluding the ones during apnea events; (4) excluding the ones before and after apnea events; (5) combining configurations 2 and 3; and (6) combining configurations 2 and 4. For each of these configurations, the discrimination capability of the indices was tested for the following comparisons: (1) (C, PD-RBD, PLMD) vs (PD + RBD, RBD); (2) C vs RBD; (3) PLMD vs RBD; (4) C vs PD-RBD; (5) C vs PLMD; (6) PD-RBD vs PD + RBD; and (7) C vs PLMD vs RBD. Results showed varying methods’ performances across the different configurations and comparisons, making it impossible to identify the optimal method and suggesting the need of further improvements. Nevertheless, RAI seems the most sensible one for RBD detection. Moreover, apnea and arousal-related movements seem not to influence the algorithms’ performances in patients’ classification.",
keywords = "Automated method, Computerized analysis, Electromyography, Parkinson’s disease, Polysomnography, REM sleep behavior disorder, REM sleep without atonia",
author = "Matteo Cesari and Christensen, {Julie Anja Engelhard} and Lykke Kempfner and Olesen, {Alexander Neergaard} and Geert Mayer and Karl Kesper and Oertel, {Wolfgang H} and Friederike Sixel-D{\"o}ring and Claudia Trenkwalder and S{\o}rensen, {Helge Bjarup Dissing} and Poul Jennum",
year = "2018",
doi = "10.1093/sleep/zsy133",
language = "English",
volume = "41",
journal = "Sleep (Online)",
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Cesari, M, Christensen, JAE, Kempfner, L, Olesen, AN, Mayer, G, Kesper, K, Oertel, WH, Sixel-Döring, F, Trenkwalder, C, Sørensen, HBD & Jennum, P 2018, 'Comparison of computerized methods for rapid eye movement sleep without atonia detection', Sleep, vol. 41, no. 10. https://doi.org/10.1093/sleep/zsy133

Comparison of computerized methods for rapid eye movement sleep without atonia detection. / Cesari, Matteo; Christensen, Julie Anja Engelhard; Kempfner, Lykke; Olesen, Alexander Neergaard; Mayer, Geert; Kesper, Karl; Oertel, Wolfgang H; Sixel-Döring, Friederike; Trenkwalder, Claudia; Sørensen, Helge Bjarup Dissing; Jennum, Poul.

In: Sleep, Vol. 41, No. 10, 2018.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Comparison of computerized methods for rapid eye movement sleep without atonia detection

AU - Cesari, Matteo

AU - Christensen, Julie Anja Engelhard

AU - Kempfner, Lykke

AU - Olesen, Alexander Neergaard

AU - Mayer, Geert

AU - Kesper, Karl

AU - Oertel, Wolfgang H

AU - Sixel-Döring, Friederike

AU - Trenkwalder, Claudia

AU - Sørensen, Helge Bjarup Dissing

AU - Jennum, Poul

PY - 2018

Y1 - 2018

N2 - Rapid eye movement (REM) sleep without atonia detection is a prerequisite for diagnosis of REM sleep behavior disorder (RBD). As the visual gold standard method is time-consuming and subjective, several automated methods have been proposed. This study aims to compare their performances: The REM atonia index (RAI), the supra-threshold-REM-activity metric, the Frandsen index, the short/long muscle activity indices, and the Kempfner index algorithms were applied to 27 healthy control participants (C), 25 patients with Parkinson’s disease (PD) without RBD (PD-RBD), 29 patients with PD and RBD (PD + RBD), 29 idiopathic patients with RBD, and 36 patients with periodic limb movement disorder (PLMD). The indices were calculated in various configurations: (1) considering all muscle activities; (2) excluding the ones related to arousals; (3) excluding the ones during apnea events; (4) excluding the ones before and after apnea events; (5) combining configurations 2 and 3; and (6) combining configurations 2 and 4. For each of these configurations, the discrimination capability of the indices was tested for the following comparisons: (1) (C, PD-RBD, PLMD) vs (PD + RBD, RBD); (2) C vs RBD; (3) PLMD vs RBD; (4) C vs PD-RBD; (5) C vs PLMD; (6) PD-RBD vs PD + RBD; and (7) C vs PLMD vs RBD. Results showed varying methods’ performances across the different configurations and comparisons, making it impossible to identify the optimal method and suggesting the need of further improvements. Nevertheless, RAI seems the most sensible one for RBD detection. Moreover, apnea and arousal-related movements seem not to influence the algorithms’ performances in patients’ classification.

AB - Rapid eye movement (REM) sleep without atonia detection is a prerequisite for diagnosis of REM sleep behavior disorder (RBD). As the visual gold standard method is time-consuming and subjective, several automated methods have been proposed. This study aims to compare their performances: The REM atonia index (RAI), the supra-threshold-REM-activity metric, the Frandsen index, the short/long muscle activity indices, and the Kempfner index algorithms were applied to 27 healthy control participants (C), 25 patients with Parkinson’s disease (PD) without RBD (PD-RBD), 29 patients with PD and RBD (PD + RBD), 29 idiopathic patients with RBD, and 36 patients with periodic limb movement disorder (PLMD). The indices were calculated in various configurations: (1) considering all muscle activities; (2) excluding the ones related to arousals; (3) excluding the ones during apnea events; (4) excluding the ones before and after apnea events; (5) combining configurations 2 and 3; and (6) combining configurations 2 and 4. For each of these configurations, the discrimination capability of the indices was tested for the following comparisons: (1) (C, PD-RBD, PLMD) vs (PD + RBD, RBD); (2) C vs RBD; (3) PLMD vs RBD; (4) C vs PD-RBD; (5) C vs PLMD; (6) PD-RBD vs PD + RBD; and (7) C vs PLMD vs RBD. Results showed varying methods’ performances across the different configurations and comparisons, making it impossible to identify the optimal method and suggesting the need of further improvements. Nevertheless, RAI seems the most sensible one for RBD detection. Moreover, apnea and arousal-related movements seem not to influence the algorithms’ performances in patients’ classification.

KW - Automated method

KW - Computerized analysis

KW - Electromyography

KW - Parkinson’s disease

KW - Polysomnography

KW - REM sleep behavior disorder

KW - REM sleep without atonia

U2 - 10.1093/sleep/zsy133

DO - 10.1093/sleep/zsy133

M3 - Journal article

C2 - 30011023

VL - 41

JO - Sleep (Online)

JF - Sleep (Online)

SN - 0161-8105

IS - 10

ER -