手动定量评估过度片段性肌阵挛的振幅和睡眠阶段分布。

Manual quantitative assessment of amplitude and sleep stage distribution of excessive fragmentary myoclonus.

机构信息

Department of Neurology, Division of Sleep Medicine, Louisiana State University School of Medicine, Shreveport, LA 71101, USA.

出版信息

J Clin Sleep Med. 2013 Jan 15;9(1):39-45. doi: 10.5664/jcsm.2336.

DOI:10.5664/jcsm.2336

PMID:23319903

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3525986/

Abstract

INTRODUCTION

Excessive fragmentary myoclonus (EFM) consists of brief, asynchronous, twitch-like movements appearing asymmetrically in sleep. The new AASM Manual for the Scoring of Sleep and Associated Events identifies some EFM scoring criteria but does not provide amplitude criteria for scoring EFM. Older observational series have used 50 μVs. We report data from various amplitude criteria using blinded comparisons.

METHODS

EFMs were analyzed on the polysomnograms of 8 patients (7 men and 1 woman, mean age 57 years, range: 47-79) using a standardized protocol for sensitivity, tonus threshold, impedance, amplitude measurements, and sleep stage. The first 20 minutes each of wake, Stage 1-2, SWS, and REM were analyzed. EFMs ≥ 25, ≥ 40, and ≥ 50 microvolts (μVs) in negative deflection above the baseline were counted in tibialis anterior muscle electromyography (EMG) channels bilaterally.

RESULTS

The mean EFM index per minute for wake, regardless of impedance, was: 7.19 ± 5.90 for ≥ 25 μV amplitude; 2.43 ± 2.02 for ≥ 40 μVs; and 2.08 ± 2.23 for ≥ 50 μVs. For sleep stages, the EFM index by stage and amplitude criteria used for measurements were: Stage 1-2: 7.38 ± 5.79 for ≥ 25 μVs; 3.13 ± 3.33 for ≥ 40 μVs; and 2.36 ± 2.66 for ≥ 50 μVs; SWS: 10.05 ± 8.04 for ≥ 25 μVs; 2.71 ± 3.13 for ≥ 40 μVs; and 1.38 ± 1.92 for ≥ 50 μVs; Total REM: 15.96 ± 11.32 for ≥ 25 μVs; 6.32 ± 4.25 for ≥ 40 μVs; and 3.94 ± 3.73 for ≥ 50 μVs; Phasic REM: 19.69 ± 15.45 for ≥ 25 μVs; 8.63 ± 7.06 for ≥ 40 μVs; and 5.52 ± 6.44 for ≥ 50 μVs; Non-phasic REM: 13.93 ± 11.31 for ≥ 25 μVs; 5.16 ± 3.57 for ≥ 40 μVs; and 3.20 ± 2.92 for ≥ 50 μVs.

CONCLUSION

EFM rates increase with SWS and total REM with the highest EFM rates occurring during phasic REM. EFM rates were increased across all sleep stages when impedance was > 30 KΩ.

摘要

简介

过度片段性肌阵挛（EFM）由睡眠中不对称出现的短暂、异步、抽搐样运动组成。新的 AASM 睡眠和相关事件评分手册确定了一些 EFM 评分标准，但未提供 EFM 评分的幅度标准。较旧的观察性系列使用了 50μV。我们报告了使用盲法比较的各种幅度标准的数据。

方法

使用标准化的敏感性、张力阈值、阻抗、幅度测量和睡眠阶段协议，对 8 名患者（7 名男性和 1 名女性，平均年龄 57 岁，范围：47-79 岁）的多导睡眠图中的 EFM 进行分析。分析了清醒、第 1-2 阶段、慢波睡眠和 REM 期的前 20 分钟。双侧胫骨前肌肌电图（EMG）通道中记录的负向偏转幅度≥25、≥40 和≥50 微伏（μV）的 EFM 计数。

结果

无论阻抗如何，清醒时 EFM 指数每分钟为：≥25μV 幅度为 7.19±5.90；≥40μVs 为 2.43±2.02；≥50μVs 为 2.08±2.23。对于睡眠阶段，使用测量的幅度标准的 EFM 指数为：第 1-2 阶段：≥25μVs 为 7.38±5.79；≥40μVs 为 3.13±3.33；≥50μVs 为 2.36±2.66；慢波睡眠：≥25μVs 为 10.05±8.04；≥40μVs 为 2.71±3.13；≥50μVs 为 1.38±1.92；总 REM：≥25μVs 为 15.96±11.32；≥40μVs 为 6.32±4.25；≥50μVs 为 3.94±3.73；相位 REM：≥25μVs 为 19.69±15.45；≥40μVs 为 8.63±7.06；≥50μVs 为 5.52±6.44；非相位 REM：≥25μVs 为 13.93±11.31；≥40μVs 为 5.16±3.57；≥50μVs 为 3.20±2.92。