Loo Hui-Voon, Tan Eng-King
Department of Neurology, Singapore General Hospital National Neuroscience Institute SingHealth, Singapore.
J Neurol Sci. 2008 Mar 15;266(1-2):145-9. doi: 10.1016/j.jns.2007.09.033. Epub 2007 Oct 17.
In a case-control study involving 400 study subjects, we found a higher prevalence of restless legs syndrome (RLS) in our Parkinson's disease (PD) patients compared to controls (3.0% vs 0.5%) (odds ratio 6.2) (p=0.07). Polysomnographic studies confirmed that study subjects with RLS had grossly elevated PLMS index, PLMS arousal index and reduced sleep efficiency. None of these PD patients reported a family history of PD or RLS. The average age of onset of RLS was 61.7+/-10.8 years old. The mean global Pittsburgh Sleep Quality Index (PSQI) score of PD patients was significantly higher than the controls (9.1+/-4.5 vs 4.3+/-2.8, p<0.0001). All the seven components of PSQI in PD patients were significantly different from controls (p<0.0001). Multivariate analysis revealed that only Hoehn and Yahr staging correlated with the global PSQI score (p<0.0001). Similar results were obtained when we compared the PSQI score between PD patients without RLS with controls. Our case-control study demonstrated a weak association between RLS and PD. PD patients have significant poor quality of sleep, and this correlated with the severity of PD. RLS did not play an important role in sleep dysfunction in our PD cohort. A high index of suspicion for sleep problems in advanced PD patients is important as early management could improve their quality of life.
在一项涉及400名研究对象的病例对照研究中,我们发现帕金森病(PD)患者中不安腿综合征(RLS)的患病率高于对照组(3.0%对0.5%)(优势比6.2)(p = 0.07)。多导睡眠图研究证实,患有RLS的研究对象的周期性肢体运动指数(PLMS)、PLMS觉醒指数显著升高,睡眠效率降低。这些PD患者均未报告有PD或RLS的家族病史。RLS的平均发病年龄为61.7±10.8岁。PD患者的匹兹堡睡眠质量指数(PSQI)全球平均得分显著高于对照组(9.1±4.5对4.3±2.8,p<0.0001)。PD患者PSQI的所有七个组成部分与对照组均有显著差异(p<0.0001)。多变量分析显示,只有Hoehn和Yahr分期与PSQI全球得分相关(p<0.0001)。当我们比较无RLS的PD患者与对照组的PSQI得分时,得到了相似的结果。我们的病例对照研究表明RLS与PD之间存在弱关联。PD患者的睡眠质量明显较差,且这与PD的严重程度相关。在我们的PD队列中,RLS在睡眠功能障碍中未起重要作用。对晚期PD患者的睡眠问题保持高度怀疑指数很重要,因为早期管理可以改善他们的生活质量。