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  • Wiley  (8)
  • Brandauer, Elisabeth  (8)
  • 1
    Online Resource
    Online Resource
    Factors associated with augmentation in patients with restless legs syndrome
    Wiley ; 2022
    In:  European Journal of Neurology Vol. 29, No. 4 ( 2022-04), p. 1227-1231
    Details
    In: European Journal of Neurology, Wiley, Vol. 29, No. 4 ( 2022-04), p. 1227-1231
    Abstract: Augmentation is a paradoxical reaction mainly to dopaminergic medication in patients with restless legs syndrome (RLS), but the exact pathomechanism remains unclear. The aim of this study was to identify factors associated with augmentation in RLS patients. Methods RLS patients with and without current or previous augmentation were recruited. Demographic characteristics, history of smoking, questionnaires for depression, alexithymia, and impulsivity, and RLS severity were obtained. Results We included 122 patients, of whom half had a history of augmentation. Patients with augmentation had a longer disease duration ( p  = 0.001), had higher RLS severity scores ( p  = 0.013), had higher levodopa equivalent doses ( p 〈 0.001), had higher scores for alexithymia ( p  = 0.028), had higher prevalence of impulse control disorders ( p   〈  0.001), more often had a history of smoking ( p  = 0.039), were more often currently smoking ( p  = 0.015), and had more average pack‐years ( p  = 0.016). Conclusions Here, we describe several factors commonly associated with augmentation in RLS. These may help clinicians to screen and treat patients carefully to avoid the challenging side effect of augmentation.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v29.4
    DOI: 10.1111/ene.15221
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2020241-6
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  • 2
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    Language analysis of spontaneous descriptions of restless legs syndrome: Gender differences?
    Wiley ; 2022
    In:  Journal of Sleep Research Vol. 31, No. 1 ( 2022-02)
    Details
    In: Journal of Sleep Research, Wiley, Vol. 31, No. 1 ( 2022-02)
    Abstract: Patients with restless legs syndrome (RLS) use various terms when describing their symptoms. Whether gender might influence this has not been investigated so far. The aim of this study was to evaluate possible gender differences in spontaneous descriptions of RLS symptoms. This prospective study, conducted in 100 consecutive German‐speaking RLS patients, used a single standardized question. Answers were digitally recorded and transcribed. A content‐related linguistic analysis of the transcripts was performed by two independent blinded raters. The lengths of the answers and content‐related linguistic features were compared between women and men. Ninety‐eight patients were included in the final analysis, 59 women (60.2%) and 39 men (39.8%), with a median age of 62 (23–94) and 63 (31–82) years, respectively ( p  = 0.602). Demographic and clinical features, including educational level and RLS treatment class, did not differ between genders ( p   〉  0.05). Total word or sentence count showed no gender differences ( p  = 0.159 and 0.259, respectively), although men used more words per sentence than women ( p  = 0.018). More men than women described quiescegenic (i.e., triggered by rest or inactivity) symptoms ( p  = 0.006) and successful attempts at relief ( p  = 0.039). There was a non‐significant trend toward a more frequent use of the first‐person perspective in men (median times used = 5 [0–10.5] vs. 3.8 [0–17.5] , p  = 0.068). The more frequent mention of quiescegenic symptoms and successful attempts at relief in men could indicate differences in phenotypic presentation of RLS between genders, a more precise description of RLS symptoms or a higher experience of self‐efficacy in men compared to women.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.v31.1
    DOI: 10.1111/jsr.13433
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2007459-1
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  • 3
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    A reliable automatic algorithm to score fragmentary myoclonus
    Wiley ; 2023
    In:  Journal of Sleep Research Vol. 32, No. 5 ( 2023-10)
    Details
    In: Journal of Sleep Research, Wiley, Vol. 32, No. 5 ( 2023-10)
    Abstract: Excessive fragmentary myoclonus (EFM) is an incidental polysomnographic finding requiring documentation of ≥20 minutes of NREM sleep with ≥5 fragmentary myoclonus (FM) potentials per minute. Manual FM scoring is time‐consuming and prone to inter‐rater variability. This work aimed to validate an automatic algorithm to score FM in whole‐night recordings. One expert scorer manually scored FM in the anterior tibialis muscles in 10 polysomnographies of as many subjects. The algorithm consisted of two steps. First, parameters of the automatic leg movement identification algorithm of the BrainRT software (OSG, Belgium) were modified to identify FM‐like activity. Second, a post‐processing algorithm was implemented to remove FM activity not meeting sufficient amplitude criteria. The parameter choice and the post‐processing were optimised with leave‐one‐out cross‐validation. Agreement with the human scorer was measured with Cohen's kappa (k) and correlation between manual and automatic FM indices in different sleep stages was evaluated. Agreement in identifying patients with EFM was computed. The algorithm showed substantial agreement (average k  〉  0.62) for all sleep stages, except for W, where a moderate agreement was observed (average k = 0.58). Nonetheless, the agreement between human scorer and the algorithm was similar to previously reported values of inter‐rater variability for FM scoring. Correlation coefficients were over 0.96 for all sleep stages. Furthermore, the presence/absence of EFM was correctly identified in 80% of the subjects. In conclusion, this work presents a reliable algorithm for automatic scoring of FM and EFM. Future studies will apply it to objectively and consistently evaluate FM indices and the presence of EFM in large populations.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.v32.5
    DOI: 10.1111/jsr.13921
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 4
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    A 24% prevalence of excessive fragmentary myoclonus in 500 consecutive sleep laboratory patients
    Wiley ; 2024
    In:  Journal of Sleep Research Vol. 33, No. 3 ( 2024-05)
    Details
    In: Journal of Sleep Research, Wiley, Vol. 33, No. 3 ( 2024-05)
    Abstract: Excessive fragmentary myoclonus (EFM) is a frequent finding during routine video‐polysomnography (VPSG). We aimed to automatically measure the prevalence of EFM according to current American Academy of Sleep Medicine (AASM) criteria, and the fragmentary myoclonus index (FMI) in sleep stage N1, N2, N3, rapid eye movement (REM) sleep and wake in a large patient population. A total of 500 VPSG recordings of patients admitted to the Sleep Laboratory, Department of Neurology, Medical University of Innsbruck, Austria, between May 1, 2022 and February 28, 2023, were included. EFM according to AASM criteria and FMI were computed by applying a previously validated algorithm. EFM was automatically detected in 121 of the 500 Sleep Laboratory patients (24.2%, 95% confidence interval 20.1%–28.9%). FMI increased with age, male gender, apnea–hypopnea‐index (AHI), oxygen desaturation index (ODI), and periodic leg movements of sleep (PLMS) index. FMI was highest in REM sleep behaviour disorder (RBD), followed by neurodegenerative and internal medicine diseases, but the increase in the FMI was not explained by the disease itself but rather by the age and sex of the patients. Almost a quarter of our patient population had EFM. However, the prevalence of EFM does not allow the drawing of any conclusions about the pathophysiology of EFM or even the determination of a pathological FMI cut‐off value. Associations of the FMI with age, sex, AHI, ODI and PLMS are in line with previous studies, but the FMI needs to be evaluated in different disease entities to learn more about its pathophysiology.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.v33.3
    DOI: 10.1111/jsr.14074
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2007459-1
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  • 5
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    Low Specificity of Rapid Eye Movement Sleep Behavior Disorder Questionnaires: Need for Better Screening Methods
    Wiley ; 2023
    In:  Movement Disorders Vol. 38, No. 6 ( 2023-06), p. 1000-1007
    Details
    In: Movement Disorders, Wiley, Vol. 38, No. 6 ( 2023-06), p. 1000-1007
    Abstract: Correct diagnosis of rapid eye movement sleep behavior disorder (RBD) is critical due to its link to α‐synucleinopathies and risk of injuries and requires video‐polysomnography (V‐PSG). Usefulness of screening questionnaires outside the context of validation studies is limited. Objective The aim was to assess the performance of three validated RBD screening questionnaires compared with gold‐standard V‐PSG. Methods In this bicentric prospective study, 400 consecutive subjects referred to a sleep center for the first time filled three RBD questionnaires (RBD Screening Questionnaire, RBD Single Question, and Innsbruck RBD Inventory) in random order before sleep experts' interview. Subjects positive for at least one questionnaire were invited to undergo V‐PSG. Data from patients negative for all questionnaires undergoing V‐PSG for other reasons were also evaluated. Questionnaire performances were compared to gold‐standard V‐PSG RBD diagnosis. Results Three hundred ninety‐nine patients (median age: 51 [interquartile range: 37–64] years, 54.9% men) participated. Two hundred thirty‐eight (59.6%) were positive for at least one questionnaire, and RBD was diagnosed using V‐PSG in 30 patients (7.5%). Questionnaire specificity was 48.1% to 67.4%, sensitivity 80% to 92%, accuracy 51% to 68.3%, negative predictive value 94.2% to 98%, and positive predictive value 14.1% to 20.7%, with no relevant differences in performances among the evaluated questionnaires. Conclusions RBD questionnaires have low specificity and low positive predictive value and should not be used as a standalone tool for the diagnosis of RBD. Further development of RBD screening methods is needed, particularly for upcoming neuroprotective trials. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v38.6
    DOI: 10.1002/mds.29407
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2041249-6
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  • 6
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    Augmentation in restless legs syndrome: an eye tracking study on emotion processing
    Wiley ; 2020
    In:  Annals of Clinical and Translational Neurology Vol. 7, No. 9 ( 2020-09), p. 1620-1627
    Details
    In: Annals of Clinical and Translational Neurology, Wiley, Vol. 7, No. 9 ( 2020-09), p. 1620-1627
    Abstract: To assess emotional processing and alexithymia in patients with restless legs syndrome (RLS) with augmentation versus those who never had augmentation. Methods We recruited 26 patients who had a history of augmentation (AUG), either current or past, 27 RLS patients treated with dopamine agonists who never had augmentation (RLS controls), and 21 healthy controls (HC). All participants were screened for impulse control disorders (ICDs). Alexithymia was assessed by means of the Toronto Alexithymia Scale – 20 (TAS‐20). Facial emotion recognition was tested through an eye‐tracking task. Furthermore, all participants performed neuropsychological tests assessing global cognitive status, impulsivity, anxiety, and depression. Results ICD symptoms occurred more frequently in AUG patients than in RLS controls ( P  = 0.047). Patients with AUG scored higher on the TAS‐20 ( P  = 0.007) and the attentional subdomain of an impulsivity scale (BIS‐11; P  = 0.015) compared to HC. Patients with AUG also performed worse on the facial emotion recognition task relative to RLS controls ( P  = 0.009) and HC ( P  = 0.003). We found a group difference for the time to first fixation and the fixation count in the mouth region ( P  = 0.019 and P  = 0.021, respectively). There were no other differences in the eye tracking examination. Interpretation This study showed evidence of poorer emotional processing in patients who had augmentation compared to RLS patients without augmentation and healthy controls. The altered exploration pattern of faces and the higher alexithymia scores suggest abnormalities in emotion processing in patients with augmentation.
    Type of Medium: Online Resource
    ISSN: 2328-9503 , 2328-9503
    URL: Issue
    URL: Article
    DOI: 10.1002/acn3.v7.9
    DOI: 10.1002/acn3.51144
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2740696-9
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  • 7
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    Is REM Sleep Behavior Disorder Changing? Secular Changes Versus Referral Patterns
    Wiley ; 2023
    In:  Movement Disorders Clinical Practice
    Details
    In: Movement Disorders Clinical Practice, Wiley
    Abstract: Since 2014, there has been increasing public outreach effort regarding isolated/idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) in Montreal. Objective To assess if, over time, milder iRBD cases are presenting earlier. Methods Disease‐free survival was compared in two iRBD recruitment epochs: 2004 to 2013 (“earlier”) versus 2014to 2022 (“later ” ) and by referral type (“self‐referral” vs. “conventional‐referral”) in three large centers. Results In Montreal, among 209 subjects followed prospectively, shorter time to phenoconversion was observed in the earlier epoch (5‐year phenoconversion = 42% earlier vs. 23% later); diagnosis before 2014 had a 1.8‐fold phenoconversion hazard. However, no difference was observed in 248 subjects from Barcelona and 166 from Innsbruck. Analysis of Montreal data found that increased survival in the later epoch was driven by an increasing number of self‐referrals, who phenoconverted at 1/3 the rate of physician‐referred subjects. Conclusions Increased patient awareness of iRBD results in earlier presentation to clinical attention, with a longer time to phenoconversion.
    Type of Medium: Online Resource
    ISSN: 2330-1619 , 2330-1619
    URL: Article
    DOI: 10.1002/mdc3.13842
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2772809-2
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  • 8
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    Improved automatic identification of isolated rapid eye movement sleep behavior disorder with a 3D time‐of‐flight camera
    Wiley ; 2023
    In:  European Journal of Neurology Vol. 30, No. 8 ( 2023-08), p. 2206-2214
    Details
    In: European Journal of Neurology, Wiley, Vol. 30, No. 8 ( 2023-08), p. 2206-2214
    Abstract: Automatic 3D video analysis of the lower body during rapid eye movement (REM) sleep has been recently proposed as a novel tool for identifying people with isolated REM sleep behavior disorder (iRBD), but, so far, it has not been validated on unseen subjects. This study aims at validating this technology in a large cohort and at improving its performances by also including an analysis of movements in the head, hands and upper body. Methods Fifty‐three people with iRBD and 128 people without RBD (of whom 89 had sleep disorders considered RBD differential diagnoses) were included in the study. An automatic algorithm identified movements from 3D videos during REM sleep in four regions of interest (ROIs): head, hands, upper body and lower body. The movements were divided into categories according to duration: short (0.1–2 s), medium (2–15 s) and long (15–300 s). For each ROI and duration range, features were obtained from the identified movements. Logistic regression models using as predictors the features from one single ROI or a combination of ROIs were trained and tested in a 10‐runs 10‐fold cross‐validation scheme on the task of differentiating people with iRBD from people without RBD. Results The best differentiation was achieved using short movements in all four ROIs (test accuracy 0.866 ± 0.007, test F1 score = 0.783 ± 0.010). Single group analyses showed that people with iRBD were distinguished successfully from subjects with RBD differential diagnoses. Conclusions Automatic 3D video analysis might be implemented in clinical routine as a supportive screening tool for identifying people with RBD.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v30.8
    DOI: 10.1111/ene.15822
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2020241-6
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