Objective: Assess the Tanner’s Questionnaire (TQ) and the REM Sleep Behavior Disorder Single-Question Screen (RBD1Q) performance as screening tools for Parkinson’s Disease (PD) in a Brazilian cohort.

Background: Limited data exist on PD screening tools’ diagnostic performance in Brazil, with only one prior study assessing TQ[1]. The RBD1Q is used to screen for REM Sleep Behaviour Disorder, which can be an early manifestation of PD[2]. We aimed to investigate if these tools or their combination could improve the screening process and assess their psychometric characteristics in this cohort.

Method: Patients from a PROBE-PD study cohort were screened by phone and evaluated in person by a neurologist to define the PD diagnosis using the UK Brain Bank Criteria[3]. The TQ contains 9 yes/no questions regarding PD symptoms, with ≥ 2 affirmatives constituting a positive screening, with reported sensitivity and specificity of 100% and 29% for PD[1]. The RBD1Q comprises a single question regarding ‘acting out’ dreams[2]. Sensitivity, specificity, and 95% confidence intervals (CI) were calculated. Subgroup analyses were performed for sex and education to explore characteristics that could influence test performance.

Results: Of 1322 participants, 44 had a PD diagnosis. Most were female (58.5%) and had < 6 years of formal education (61.5%). A TQ ≥ 2 had a sensitivity of 88.6% (79.3%-98%) and a specificity of 35.1% (CI 32.5%-37.8%); and the RBD1Q had a sensitivity of 29.5% (16.1%-43%) and a specificity of 70.8% (68.3%-73.3%) for diagnosing PD. The TQ performed better in males and those with ≥ 6 years of study. The RBD1Q performed better in females and suffered minimal effect from education years [table1]. Having either TQ ≥ 2 or a positive RBD1Q had a sensitivity of 90.9% (82.4%-99.4%) and specificity of 21.4% (19.2%-23.7%).

Conclusion: The sensitivity and specificity of the tests, especially the TQ, differed from the literature, possibly related to cultural, ethno-racial, social, screening methods, or sampling differences between current and past cohorts[1,4,5]. Combining tests slightly improved sensitivity but decreased specificity. Future studies could explore other characteristics related to changes in the diagnostic performance or propose new screening methods with higher sensitivity and specificity.

Table 1. Subgroup analysis

References: References:
[1]. Barbosa, M. T. et al. Parkinsonism and Parkinson’s disease in the elderly: A community‐based survey in Brazil (the Bambuí study). Movement Disorders 21, 800–808 (2006).
[2]. Postuma, R. B. et al. A single‐question screen for rapid eye movement sleep behavior disorder: A multicenter validation study. Movement Disorders 27, 913–916 (2012).
[3]. Pereira, G. M. et al. Prevalence and incidence of Parkinson’s disease and other forms of parkinsonism in a cohort of elderly individuals in Southern Brazil: protocol for a population-based study. BMJ Open 11, e054423 (2021).

[4]. Dakay, D. et al. Cross-cultural validation of the Cebuano version of a screening questionnaire for Parkinson’s disease. Arq Neuropsiquiatr 80, 1239–1245 (2022).
[5]. Wei, Z. et al. Evaluation of a screening questionnaire for Parkinson’s disease in a Chinese population. Journal of Clinical Neuroscience 21, 278–281 (2014).

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/accuracy-of-the-tanners-questionnaire-and-the-rem-sleep-behavior-disorder-single-question-screen-as-screening-tools-for-parkinsons-disease-in-a-brazilian-cohort/