Haba-Rubio José, Sforza Emilia
Sleep Laboratory, Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland.
Sleep Med. 2006 Oct;7(7):561-6. doi: 10.1016/j.sleep.2006.02.007. Epub 2006 Sep 22.
To evaluate the test-to-test variability of the suggested immobilization test (SIT) in patients with restless legs syndrome (RLS).
Twenty patients with primary RLS (12 men and eight women; age: 53.3+/-11.3 years) were selected for the study. We compared the results of two SITs performed on two consecutive evenings prior to polysomnographic recordings.
Overall, the periodic leg movement index during the SIT (SIT PLM) and the SIT PLM index associated with sensory manifestations (SIT PLM+) were not significantly different between tests. The number of PLM sequences per SIT, the mean PLM duration and the PLM interval did not significantly change between the two consecutive tests. The pattern of temporal evolution of motor activity across the SIT was very reproducible, SIT PLM showing a clear tendency to a progressive increase across the test, with the SIT PLM+ index decreasing in the second half of the test. Despite good reproducibility, there were marked intra-individual differences. Considering the proposed cut-off value of 12 for the SIT PLM index to confirm RLS, 11 patients were positive at the first test and four additional patients became positive at the second test. SIT PLM index changes did not correlate with age, severity of disease and polysomnographic measures.
Quantitative analysis of motor activity during two consecutive SITs in RLS patients showed a significant inter-test intra-individual variability unrelated to demographic, clinical or polysomnographic parameters. SIT PLM index variability suggests that a single test would not be sensitive enough for diagnostic purposes in unclear cases and that new criteria need to be applied to increase its specificity and sensitivity.
评估不安腿综合征（RLS）患者中建议的固定试验（SIT）的测试间变异性。
选取20例原发性RLS患者（12例男性和8例女性；年龄：53.3±11.3岁）进行研究。我们比较了在多导睡眠图记录前连续两个晚上进行的两次SIT的结果。
总体而言，两次测试之间，SIT期间的周期性腿部运动指数（SIT PLM）以及与感觉表现相关的SIT PLM指数（SIT PLM+）无显著差异。两次连续测试之间，每次SIT的PLM序列数量、平均PLM持续时间和PLM间隔均无显著变化。整个SIT过程中运动活动的时间演变模式具有高度可重复性，SIT PLM显示出在测试过程中有逐渐增加的明显趋势，而SIT PLM+指数在测试后半段下降。尽管具有良好的可重复性，但个体内部存在显著差异。考虑到用于确诊RLS的SIT PLM指数建议临界值为12，11例患者在第一次测试时呈阳性，另外4例患者在第二次测试时变为阳性。SIT PLM指数变化与年龄、疾病严重程度和多导睡眠图测量结果无关。
对RLS患者连续两次SIT期间的运动活动进行定量分析显示，测试间个体内部存在显著变异性，且与人口统计学、临床或多导睡眠图参数无关。SIT PLM指数的变异性表明，在不明确的病例中，单次测试对于诊断目的不够敏感，需要应用新的标准来提高其特异性和敏感性。
