Optimizing MSLT Specificity in Narcolepsy With Cataplexy
Optimizing MSLT Specificity in Narcolepsy With Cataplexy
复制标题
优化 MSLT 在猝倒发作性睡病中的特异性
作者：
Tobias Murer;L. Imbach;M. Hackius;R. Taddei;E. Werth;R. Poryazova;Yury V. Gavrilov;Sophie Winkler;D. Waldvogel;C. Baumann;P. Valko
Study Objectives
Multiple sleep onset rapid eye movement (R) periods (SOREMPs) and a mean sleep latency of ≤8 minutes on the multiple sleep latency test (MSLT) are diagnostic criteria of narcolepsy (NC), but also occur in other conditions with increased sleep pressure, including insufficient sleep syndrome (ISS), sleep-disordered breathing (SDB), or Parkinson's disease (PD). These false positives are common, may create diagnostic uncertainty, and highlight the need for complementary MSLT measures with high specificity for NC.
Methods
Detailed analysis of MSLT findings in 56 NC, 83 PD, 89 SDB, and 23 ISS patients, using receiver operating characteristic curves.
Results
A positive MSLT (mean sleep latency ≤ 8.0 minutes and ≥2 SOREMPs) was found in 53 NC (95%), 1 PD (1%), 8 SDB (9%), and 12 ISS patients (52%). MSLT-based differentiation between NC and non-NC patients was best when applying a mean R latency of ≤5 minutes (sensitivity/specificity/positive predictive value [PPV]: 49%/95%/96%) or a mean percentage of sleep stage R ≥ 40% (sensitivity/specificity/PPV: 60%/100%/100%) as cutoffs. When analyzing all 252 naps with SOREMPs in isolation, the combination of both R latency of ≤5 minutes and R percentage of ≥50% yielded a sensitivity/specificity/PPV of 50%/99%/99%. In addition, a sleep stage sequence with R occurring prior to N2 was more common in NC than in non-NC (71% vs. 32%, p < .001), and in combination with R percentage of ≥50% yielded a sensitivity/specificity/PPV of 53%/96%/97%.
Conclusions
A better characterization of R sleep by latency, duration, and sleep stage sequence facilitates detection of false positives and, hence, contributes to a higher MSLT specificity in NC.
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影响因子：
29
作者：
Andlauer, Olivier;Moore, Hyatt;Jouhier, Laura;Drake, Christopher;Peppard, Paul E.;Han, Fang;Hong, Seung-Chul;Poli, Francesca;Plazzi, Giuseppe;O'Hara, Ruth;Haffen, Emmanuel;Roth, Thomas;Young, Terry;Mignot, Emmanuel
通讯作者：
Mignot, Emmanuel
影响因子：
4.1
作者：
Bliwise DL;Trotti LM;Juncos JJ;Factor SA;Freeman A;Rye DB
通讯作者：
Rye DB
基于人群的样本中多个睡眠开始快速眼动期的患病率。
影响因子：
5.6
作者：
Singh,Meeta;Drake,ChristopherL;Roth,Thomas
通讯作者：
Roth,Thomas
影响因子：
4.4
作者：
D. Rye;D. Bliwise;B. Dihenia;P. Gurecki
通讯作者：
D. Rye;D. Bliwise;B. Dihenia;P. Gurecki
影响因子：
5.6
作者：
Goldbart, Aviv;Peppard, Paul;Mignot, Emmanuel
通讯作者：
Mignot, Emmanuel