Objective: The objectives of this study were to present the method and the challenges of the Rapid Eye Movement (REM) Sleep Behavior Disorder Screening Questionnaire (RBDSQ) translation into 21 languages.

Background: REM sleep behavior disorder (RBD) is illustrated by motor behaviors during REM sleep, such as talking, kicking, standing up, and even falling out of bed. These actions are due to intermittent loss of muscle atonia, normally associated with REM sleep. RBD can cause sleep disruption and severe injuries for the patient or bed partner. The disorder is strongly associated with neurodegenerative diseases, such as Parkinson’s disease, dementia with Lewy bodies or progressive supranuclear palsy. The RBDSQ is a 10-item patient self-rating scale which was developed in German as an easy and practical method to screen RBD patients. The International Parkinson and Movement Disorder Society transferred distribution and translation management of the RBDSQ to MAPI.  

Methods: In most languages, the translation process consisted of: 1) Conceptual analysis of the original RBDSQ with its developers; 2) Forward/backward translation step. The forward step (i.e., translation into the target language) used the German original and the UK English version as source versions to create two target versions, which were reconciled into one. This reconciled version was back-translated into English for quality check. For countries using a national variant of the same language (e.g., Australian English vs. UK English), an adaptation was performed.

Results: The translation process did not reveal any major difficulties since most of the behaviors assessed in the RBDSQ are cross-culturally relevant. Most of the issues belonged to the semantic and syntactic fields. For instance, the word “salutieren/saluting” created a range of queries (e.g., use formal vs. informal salute or both?) solved in collaboration with the developers. The translation of “Mücken verscheuchen/shooing away midges” led the translators to choose insects fitting their geographical location or colloquial expressions (e.g., “chasser les mouches” (flies) in French). Other examples are presented.

Conclusions: The multi-step rigorous translation methodology was key in developing 21 translations of the RBDSQ conceptually equivalent to the German original.

References: Stiasny-Kolster K, Mayer G, Schäfer S, Möller JC, Heinzel-Gutenbrunner M, Oertel WH. The REM sleep behavior disorder screening questionnaire–a new diagnostic instrument. Mov Disord. 2007 Dec;22(16):2386-93.

Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A et al; ISPOR Task Force for Translation and Cultural Adaptation. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94-104.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/translating-the-rapid-eye-movement-rem-sleep-behavior-disorder-screening-questionnaire-rbdsq-into-21-languages-using-a-standardized-methodology/