title: Early automatic detection of Parkinson's disease based on sleep recordings.
abstract: CONCLUSIONS
  Idiopathic rapid-eye-movement (REM) sleep behavior disorder (iRBD) is most likely the earliest sign of Parkinson's Disease (PD) and is characterized by REM sleep without atonia (RSWA) and consequently increased muscle activity. However, some muscle twitching in normal subjects occurs during REM sleep.
  
  
  OBJECTIVE
  There are no generally accepted methods for evaluation of this activity and a normal range has not been established. Consequently, there is a need for objective criteria.
  
  
  METHODS
  In this study we propose a full-automatic method for detection of RSWA. REM sleep identification was based on the electroencephalography and electrooculography channels, while the abnormal high muscle activity was detected from the electromyography channels, in this case the submentalis combined with left and right anterior tibialis. RSWA was identified by considering it an outlier problem, in which the number of outliers during REM sleep was used as a quantitative measure of muscle activity.
  
  
  RESULTS
  The proposed method was able to automatically separate all iRBD test subjects from healthy elderly controls and subjects with periodic limb movement disorder.
  
  
  CONCLUSIONS
  The proposed work is considered a potential automatic method for early detection of PD.
authors.affiliation: *Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark; †Center for Healthy Ageing, University of Copenhagen, Copenhagen, Denmark; ‡Department of Clinical Neurophysiology, Glostrup University Hospital, Copenhagen, Denmark; and §Danish Center for Sleep Medicine, Glostrup University Hospital, Copenhagen, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Kempfner
authors.forename: Helge B D
authors.initials: HB
authors.lastname: Sorensen
authors.forename: Miki
authors.initials: M
authors.lastname: Nikolic
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
mesh_terms: D000328:Adult; D000368:Aged; D058256:Brain Waves / Q000502:physiology*; D003718:Denmark; D042241:Early Diagnosis; D004569:Electroencephalography; D004576:Electromyography; D001330:Electronic Data Processing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult