Vetrugno Roberto, D'Angelo Roberto, Cortelli Pietro, Plazzi Giuseppe, Vignatelli Luca, Montagna Pasquale
Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy.
Clin Neurophysiol. 2007 Nov;118(11):2512-8. doi: 10.1016/j.clinph.2007.08.014. Epub 2007 Sep 25.
Periodic limb movements during sleep (PLMS) in Restless Legs Syndrome (RLS) are associated with arousals and stereotyped EEG and heart rate (HR) changes. We investigated PLMS-related EEG and HR variations in multiple system atrophy (MSA) in order to detect possible abnormalities in cortical and autonomic arousal responses.
Ten patients with MSA were contrasted against ten patients with primary RLS. Cortical (EEG) and autonomic (HR) variations associated with PLMS during NREM sleep were analysed by means of Fast Fourier Transform and HR analysis. In addition, we analysed the cyclic alternating pattern (CAP) during sleep, CAP representing a measure of the spontaneous arousal oscillations during NREM sleep.
PLMS in RLS were associated with tachycardia and spectral EEG variations, beginning about 2s before the onset of PLMS, and peaking 1-4s after. The HR and spectral EEG variations were strikingly reduced or absent in MSA. MSA patients also had significantly lower CAP rate compared to RLS patients.
Blunted HR and EEG spectral changes adjacent to PLMS indicated impaired cortical and autonomic arousal responses during sleep in MSA patients.
PLMS, when present, may represent a useful means to study the arousal responses during sleep.
不宁腿综合征（RLS）患者睡眠期周期性肢体运动（PLMS）与觉醒以及刻板的脑电图（EEG）和心率（HR）变化相关。我们研究了多系统萎缩（MSA）患者中与PLMS相关的EEG和HR变化，以检测皮质和自主神经觉醒反应中可能存在的异常。
将10例MSA患者与10例原发性RLS患者进行对比。通过快速傅里叶变换和HR分析，分析非快速眼动睡眠期与PLMS相关的皮质（EEG）和自主神经（HR）变化。此外，我们分析了睡眠期间的周期性交替模式（CAP），CAP代表非快速眼动睡眠期自发觉醒振荡的一种测量方法。
RLS患者的PLMS与心动过速和EEG频谱变化相关，在PLMS发作前约2秒开始，在发作后1 - 4秒达到峰值。MSA患者的HR和EEG频谱变化明显减少或消失。与RLS患者相比，MSA患者的CAP率也显著降低。
PLMS附近HR和EEG频谱变化减弱表明MSA患者睡眠期间皮质和自主神经觉醒反应受损。
PLMS（如果存在）可能是研究睡眠期间觉醒反应的一种有用手段。
