Manconi Mauro, Ferini-Strambi Luigi, Filippi Massimo, Bonanni Enrica, Iudice Alfonso, Murri Luigi, Gigli Gian Luigi, Fratticci Lara, Merlino Giovanni, Terzano Giovanni, Granella Franco, Parrino Liborio, Silvestri Rosalia, Aricò Irene, Dattola Vincenzo, Russo Giovanna, Luongo Carmela, Cicolin Alessandro, Tribolo Antonella, Cavalla Paola, Savarese Mariantonietta, Trojano Maria, Ottaviano Salvatore, Cirignotta Fabio, Simioni Valentina, Salvi Fabrizio, Mondino Fiorella, Perla Franco, Chinaglia Giorgia, Zuliani Cristina, Cesnik Edward, Granieri Enrico, Placidi Fabio, Palmieri Maria Giuseppina, Manni Raffaele, Terzaghi Michele, Bergamaschi Roberto, Rocchi Raffaele, Ulivelli Monica, Bartalini Sabina, Ferri Raffaele, Lo Fermo Salvatore, Ubiali Emilio, Viscardi Massimo, Rottoli Mariarosa, Nobili Lino, Protti Alessandra, Ferrillo Franco, Allena Marta, Mancardi Gianluigi, Guarnieri Biancamaria, Londrillo Francesco
Sleep Disorders Center, Scientific Institute and Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy.
Sleep. 2008 Jul;31(7):944-52.
To verify the existence of a symptomatic form of restless legs syndrome (RLS) secondary to multiple sclerosis (MS) and to identify possible associated risk factors.
Prospective, multicenter, case-control epidemiologic survey.
Twenty sleep centers certified by the Italian Association of Sleep Medicine.
Eight hundred and sixty-one patients affected by MS and 649 control subjects.
N/A.
Data regarding demographic and clinical factors, presence and severity of RLS, the results of hematologic tests, and visual analysis of cerebrospinal magnetic resonance imaging studies were collected. The prevalence of RLS was 19% in MS and 4.2% in control subjects, with a risk to be affected by RLS of 5.4 (95%confidence interval: 3.56-8.26) times greater for patients with MS than for control subjects. In patients with MS, the following risk factors for RLS were significant: older age; longer MS duration; the primary progressive MS form; higher global, pyramidal, and sensory disability; and the presence of leg jerks before sleep onset. Patients with MS and RLS more often had sleep complaints and a higher intake of hypnotic medications than patients with MS without RLS. RLS associated with MS was more severe than that of control subjects.
RLS is significantly associated with MS, especially in patients with severe pyramidal and sensory disability. These results strengthen the idea that the inflammatory damage correlated with MS may induce a secondary form of RLS. As it does in idiopathic cases, RLS has a significant impact on sleep quality in patients with MS; therefore, it should be always searched for, particularly in the presence of insomnia unresponsive to treatment with common hypnotic drugs.
验证继发于多发性硬化症（MS）的症状性不安腿综合征（RLS）的存在，并确定可能的相关危险因素。
前瞻性、多中心、病例对照流行病学调查。
意大利睡眠医学协会认证的20个睡眠中心。
861例受MS影响的患者和649名对照受试者。
无。
收集了有关人口统计学和临床因素、RLS的存在和严重程度、血液学检查结果以及脑脊液磁共振成像研究的视觉分析数据。MS患者中RLS的患病率为19%，对照受试者中为4.2%，MS患者患RLS的风险是对照受试者的5.4倍（95%置信区间：3.56 - 8.26）。在MS患者中，以下RLS的危险因素具有显著性：年龄较大；MS病程较长；原发进展型MS；整体、锥体束和感觉功能障碍程度较高；睡眠开始前出现腿部抽搐。与无RLS的MS患者相比，MS合并RLS的患者更常出现睡眠问题，催眠药物摄入量更高。与MS相关的RLS比对照受试者的更严重。
RLS与MS显著相关，尤其是在锥体束和感觉功能严重受损的患者中。这些结果强化了与MS相关的炎症损伤可能诱发继发性RLS的观点。与特发性病例一样，RLS对MS患者的睡眠质量有显著影响；因此，应始终进行排查，尤其是在存在对常用催眠药物治疗无反应的失眠情况下。
