Details

Autor(en) / Beteiligte

• West, Leslie C.
• Summers, Michael
• Tang, Siqun
• Hirt, Lisa
• Halpern, Casey H.
• Maroni, Dulce
• Das, Rig
• Gliske, Stephen V.
• Abosch, Aviva
• Kushida, Clete A.
• Thompson, John A.

Titel

Evaluation of consensus sleep stage scoring of dysregulated sleep in Parkinson's disease

Ist Teil von

• Sleep medicine, 2023-07, Vol.107, p.236-242

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Sleep dysregulation in Parkinson's disease (PD) has been hypothesized to occur, in part, from dysfunction in the basal ganglia-cortical circuit. Assessment of this relationship requires accurate sleep stage determination, a known challenge in this clinical population. Our objective was to optimize the consensus on the sleep staging process and reduce interrater variability in a cohort of advanced PD subjects. Fifteen PD subjects were enrolled from three sites in a clinical trial that involved recordings from subthalamic nucleus (STN) deep brain stimulation (DBS) leads (NCT04620551). Video polysomnography (vPSG) data for a total of 45 nights were analyzed. Four experienced scorers independently scored data on initial review. Epochs with less than 75% consensus were flagged for secondary review. In secondary review of discordant epochs, two of the original scorers re-assessed epochs, from which the final consensus stage was derived. Sleep stage classification agreement averaged 83.10% across all sleep stages on initial scoring (IS), and on secondary consensus scoring (CS) review, agreement reached 96.58%. Greatest disagreement was noted in determination of awake epochs (33.6% of discordant epochs) and non-rapid-eye-movement stage 2 (N2) epochs (31.8% of discordant epochs). Scoring discrepancy was resolved with direct measurement of cortical frequency and amplitudes, physiologic context of the epoch, and video review. Our method of multi-level initial and then secondary consensus review scoring resulted in consensus scoring agreement superior to conventional standards. This work features a custom-engineered vPSG software and review platform for integration of consensus sleep stage scoring in a multi-site clinical trial. •High sleep stage classification agreement across multi-site review for Parkinson's disease.•Consensus process was superior to conventional standard sleep staging.•Intra-day consistency was high across 3-night in-hospital sleep study.