Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
J Sleep Res. 2013 Jun;22(3):315-21. doi: 10.1111/jsr.12025. Epub 2013 Feb 9.
Many patients with restless legs syndrome (Willis-Ekbom disease) complain of burning sensations in their feet associated with the desire to move, such that they seek cooler environments. This pilot study aimed to characterise the microvascular skin changes in 12 patients with restless legs syndrome compared with 12 age- and sex-matched controls. Patients with moderate or severe restless legs syndrome and controls underwent detailed thermovascular assessment in a controlled temperature room at three different stages (normothermic phase 23 °C, hot phase 30 °C, cold phase 18 °C). Microvascular activity was recorded during all phases by bilateral great toe laser-Doppler flowmetry and also by whole-body thermography. Patient and control measurements were compared. The study protocol was well tolerated. Parameters extracted from the laser-Doppler flowmetry measurements were used to model a logistic function using binary logistic regression. This demonstrated a statistically significant difference between patients with restless legs syndrome and healthy controls (P < 0.001). Visual inspection of the body thermography image sequences showed increased lower limb movement in patients with restless legs syndrome patients compared with controls. Thermography analysis also showed significant differences between foot temperatures in patients with restless legs syndrome compared with controls during the hot phase (P = 0.011). Notably, patients with restless legs syndrome had more uniform foot temperatures, whereas controls had a wider variability in surface temperature across the feet. This novel study demonstrates impaired microvascular circulation in patients with restless legs syndrome in comparison to matched controls and a potential mechanism for the sensation of burning feet. The protocol also provides an experimental paradigm to test therapeutic interventions for the future.
许多不安腿综合征（Willis-Ekbom 病）患者抱怨脚部有烧灼感，并伴有移动的欲望，因此他们会寻求更凉爽的环境。这项初步研究旨在描述 12 例不安腿综合征患者与 12 名年龄和性别匹配的对照组患者的微血管皮肤变化。中度或重度不安腿综合征患者和对照组在不同的三个阶段（正常体温 23°C、热相 30°C、冷相 18°C）在受控温度室内进行详细的热血管评估。在所有阶段，通过双侧大脚趾激光多普勒流量测量法和全身热成像来记录微血管活动。比较患者和对照组的测量结果。研究方案得到了很好的耐受。从激光多普勒流量测量中提取的参数用于使用二元逻辑回归对逻辑函数进行建模。这表明不安腿综合征患者与健康对照组之间存在统计学显著差异（P<0.001）。对全身热成像图像序列的目视检查显示，不安腿综合征患者下肢运动增加，与对照组相比。热成像分析还显示，在热相期间，不安腿综合征患者的足部温度与对照组相比存在显著差异（P=0.011）。值得注意的是，与对照组相比，不安腿综合征患者的足部温度更均匀，而对照组的足部表面温度变化更大。这项新的研究表明，与匹配的对照组相比，不安腿综合征患者的微血管循环受损，并且可能是脚部烧灼感的一种潜在机制。该方案还为未来的治疗干预措施提供了一种实验范例。
