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Abstract：
OBJECTIVE: REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment. The International RBD Study Group developed the RBD Symptom Severity Scale (RBDSSS) to assess symptom severity for clinical or research use. We assessed the psychometric and clinimetric properties of the RBDSSS in participants enrolled in the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD.
METHODS: NAPS participants, who have polysomnogram-confirmed RBD, and their bedpartners completed the RBDSSS (participant and bedpartner versions). The RBDSSS contains 8 questions to assess the frequency and severity/impact of (1) dream content, (2) vocalizations, (3) movements, and (4) injuries associated with RBD. Total scores for participant (maximum score = 54) and bedpartner (maximum score = 38) questionnaires were derived by multiplying frequency and severity scores for each question. The Clinical Global Impression Scale of Severity (CGI-S) and RBD symptom frequency were assessed by a physician during a semistructured clinical interview with participants and, if available, bedpartners. Descriptive analyses, correlations between overall scores, and subitems were assessed, and item response analysis was performed to determine the scale\'s validity.
RESULTS: Among 261 study participants, the median (interquartile range) score for the RBDSSS-PT (participant) was 10 (4-18) and that for the RBDSSS-BP (bedpartner) was 8 (4-15). The median CGI-S was 3 (3-4), indicating moderate severity. RBDSSS-BP scores were significantly lower in women with RBD (6 vs 9, p = 0.02), while there were no sex differences in RBDSSS-PT scores (8 vs 10.5, p = 0.615). Positive correlations were found between RBDSSS-PT vs RBDSSS-BP (Spearman rs = 0.561), RBDSSS-PT vs CGI-S (rs = 0.556), and RBDSSS-BP vs CGI-S (rs = 0.491, all p < 0.0001). Item response analysis showed a high discriminatory value (range 1.40-2.12) for the RBDSSS-PT and RBDSSS-BP (1.29-3.47).
CONCLUSIONS: We describe the RBDSSS with adequate psychometric and clinimetric properties to quantify RBD symptom severity and good concordance between participant and bedpartner questionnaires and between RBDSSS scores and clinician-assessed global severity.
METHODS: NAPS participants, who have polysomnogram-confirmed RBD, and their bedpartners completed the RBDSSS (participant and bedpartner versions). The RBDSSS contains 8 questions to assess the frequency and severity/impact of (1) dream content, (2) vocalizations, (3) movements, and (4) injuries associated with RBD. Total scores for participant (maximum score = 54) and bedpartner (maximum score = 38) questionnaires were derived by multiplying frequency and severity scores for each question. The Clinical Global Impression Scale of Severity (CGI-S) and RBD symptom frequency were assessed by a physician during a semistructured clinical interview with participants and, if available, bedpartners. Descriptive analyses, correlations between overall scores, and subitems were assessed, and item response analysis was performed to determine the scale\'s validity.
RESULTS: Among 261 study participants, the median (interquartile range) score for the RBDSSS-PT (participant) was 10 (4-18) and that for the RBDSSS-BP (bedpartner) was 8 (4-15). The median CGI-S was 3 (3-4), indicating moderate severity. RBDSSS-BP scores were significantly lower in women with RBD (6 vs 9, p = 0.02), while there were no sex differences in RBDSSS-PT scores (8 vs 10.5, p = 0.615). Positive correlations were found between RBDSSS-PT vs RBDSSS-BP (Spearman rs = 0.561), RBDSSS-PT vs CGI-S (rs = 0.556), and RBDSSS-BP vs CGI-S (rs = 0.491, all p < 0.0001). Item response analysis showed a high discriminatory value (range 1.40-2.12) for the RBDSSS-PT and RBDSSS-BP (1.29-3.47).
CONCLUSIONS: We describe the RBDSSS with adequate psychometric and clinimetric properties to quantify RBD symptom severity and good concordance between participant and bedpartner questionnaires and between RBDSSS scores and clinician-assessed global severity.
摘要：
目的：REM睡眠行为障碍（RBD）是一种以做梦为特征的失眠症。国际RBD研究小组开发了RBD症状严重程度量表（RBDSSS），以评估临床或研究使用的症状严重程度。我们评估了RBD北美前驱突触核蛋白病（NAPS）联盟参与者中RBDSSS的心理测量和临床特性。
方法：NAPS参与者，患有多导睡眠图证实的RBD，他们的床伴完成了RBDSSS（参与者和床伴版本）。RBDSSS包含8个问题，以评估（1）梦内容的频率和严重性/影响，(2)发声，（3）运动，(4)与RBD相关的损伤。通过乘以每个问题的频率和严重程度得分得出参与者（最高得分=54）和床伴（最高得分=38）问卷的总分。临床总体印象严重程度量表（CGI-S）和RBD症状频率由医生在与参与者进行半结构化临床访谈期间评估，如果可用，床伴。描述性分析,总分之间的相关性，和子项目进行了评估，并进行项目反应分析以确定量表的有效性。
结果：在261名研究参与者中，RBDSSS-PT(参与者)的中位数(四分位距)为10分(4~18分),RBDSSS-BP(床伴)的中位数(四分位距)为8分(4~15分).CGI-S中位数为3（3-4），表明中度严重程度。RBD女性的RBDSSS-BP评分明显较低(6vs9,p=0.02),而RBDSSS-PT评分无性别差异（8vs10.5，p=0.615）。RBDSSS-PT与RBDSSS-BP呈正相关(Spearmanrs=0.561),RBDSSS-PT与CGI-S（rs=0.556），RBDSSS-BP与CGI-S（rs=0.491，p均<0.0001）。项目响应分析显示，RBDSSS-PT和RBDSSS-BP（1.29-3.47）的判别值很高（范围为1.40-2.12）。
结论：我们描述的RBDSSS具有足够的心理测量和临床测量特性，可以量化RBD症状的严重程度，以及参与者和床伴问卷之间以及RBDSSS评分和临床医生评估的整体严重程度之间的良好一致性。
方法：NAPS参与者，患有多导睡眠图证实的RBD，他们的床伴完成了RBDSSS（参与者和床伴版本）。RBDSSS包含8个问题，以评估（1）梦内容的频率和严重性/影响，(2)发声，（3）运动，(4)与RBD相关的损伤。通过乘以每个问题的频率和严重程度得分得出参与者（最高得分=54）和床伴（最高得分=38）问卷的总分。临床总体印象严重程度量表（CGI-S）和RBD症状频率由医生在与参与者进行半结构化临床访谈期间评估，如果可用，床伴。描述性分析,总分之间的相关性，和子项目进行了评估，并进行项目反应分析以确定量表的有效性。
结果：在261名研究参与者中，RBDSSS-PT(参与者)的中位数(四分位距)为10分(4~18分),RBDSSS-BP(床伴)的中位数(四分位距)为8分(4~15分).CGI-S中位数为3（3-4），表明中度严重程度。RBD女性的RBDSSS-BP评分明显较低(6vs9,p=0.02),而RBDSSS-PT评分无性别差异（8vs10.5，p=0.615）。RBDSSS-PT与RBDSSS-BP呈正相关(Spearmanrs=0.561),RBDSSS-PT与CGI-S（rs=0.556），RBDSSS-BP与CGI-S（rs=0.491，p均<0.0001）。项目响应分析显示，RBDSSS-PT和RBDSSS-BP（1.29-3.47）的判别值很高（范围为1.40-2.12）。
结论：我们描述的RBDSSS具有足够的心理测量和临床测量特性，可以量化RBD症状的严重程度，以及参与者和床伴问卷之间以及RBDSSS评分和临床医生评估的整体严重程度之间的良好一致性。
