Michaud Martin, Dumont Marie, Selmaoui Brahim, Paquet Jean, Fantini Maria Livia, Montplaisir Jacques
Sleep Disorders Center, Sacré-Coeur Hospital, 5400 boulevard Gouin Ouest, Montréal, Quebec, Canada.
Ann Neurol. 2004 Mar;55(3):372-80. doi: 10.1002/ana.10843.
Recently, it was suggested that the intensity of restless legs syndrome (RLS) symptoms may be modulated by a circadian factor. The objective of this study was to evaluate, during a 28-hour modified constant routine, the nycthemeral or circadian variations in subjective leg discomfort and periodic leg movements (PLMs) and to parallel these changes with those of subjective vigilance, core body temperature, and salivary melatonin. Seven patients with primary RLS and seven healthy subjects matched for sex and age entered this study. Although the symptoms were more severe in patients than in controls, a significant circadian variation in leg discomfort and PLM (p < 0.01) was found for both groups. In both groups, the profiles of leg discomfort and PLM were significantly correlated with those of subjective vigilance, core body temperature, and salivary melatonin. However, among these variables, the changes in melatonin secretion were the only ones that preceded the increase in sensory and motor symptoms in RLS patients. This result and those of others studies showing that melatonin exerts an inhibitory effect on central dopamine secretion suggest that melatonin might be implicated in the worsening of RLS symptoms in the evening and during the night.
最近，有人提出不宁腿综合征（RLS）症状的强度可能受昼夜节律因素调节。本研究的目的是在28小时的改良固定日常生活程序期间，评估主观腿部不适和周期性腿部运动（PLMs）的昼夜或昼夜节律变化，并将这些变化与主观警觉性、核心体温和唾液褪黑素的变化进行对比。7名原发性RLS患者和7名年龄及性别匹配的健康受试者参与了本研究。尽管患者的症状比对照组更严重，但两组均发现腿部不适和PLM存在显著的昼夜节律变化（p < 0.01）。在两组中，腿部不适和PLM的变化曲线与主观警觉性、核心体温和唾液褪黑素的变化曲线显著相关。然而，在这些变量中，褪黑素分泌的变化是RLS患者感觉和运动症状增加之前唯一出现变化的变量。这一结果以及其他研究表明褪黑素对中枢多巴胺分泌具有抑制作用的结果提示，褪黑素可能与RLS症状在傍晚和夜间的加重有关。
