Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
Sleep Med. 2017 Feb;30:19-23. doi: 10.1016/j.sleep.2016.03.003. Epub 2016 Mar 14.
Restless legs syndrome/Willis-Ekbom disease (RLS/WED) is a sensorimotor neurological disorder, and it is especially aggravated at night. The purpose of this study was to investigate the diurnal sensory dysfunction in primary RLS/WED using the current perception threshold (CPT) test, compared to healthy controls.
Thirty primary RLS/WED subjects and 30 healthy controls were enrolled. The severity of RLS/WED and sleep problems were evaluated in all subjects. Peripheral polyneuropathy was excluded through neurological examination and nerve conduction study. We used the Neurometer system for the CPT test and applied three different parameters (2000 Hz, 250 Hz, and 5 Hz), to stimulate both big toes. The CPT test was performed twice, once during the asymptomatic daytime period and again in the evening, when the patients were symptomatic.
The mean ages of the RLS/WED group and controls were 50.5 ± 11.7 (22; 73.3% female), and 46.3 ± 11.4 (24; 80.0% female), respectively. The mean international RLS/WED study group severity scale score was 28.6 ± 4.25. There was no significant difference in the current perception thresholds between the RLS/WED patients and controls in daytime. However, the RLS/WED patients had lower mean CPT measurements for all three stimulation protocols in the evening (2000 Hz: 393.2 ± 93.7 vs 430.8 ± 79.6, 250 Hz: 172.0 ± 48.4 vs 198.5 ± 38.2, and 5 Hz: 98.0 ± 34.1 vs 124.6 ± 31.3), while the healthy controls showed no difference.
RLS patients showed a lower CPT in the evening. The diurnal variation of hyperalgesia in RLS/WED patients indicates a central (circadian) sensory processing disturbance rather than a peripheral disturbance.
不宁腿综合征/ Willis-Ekbom 病（RLS/WED）是一种感觉运动性神经系统疾病，尤其在夜间加重。本研究旨在使用当前感知阈值（CPT）测试调查原发性 RLS/WED 的日间感觉功能障碍，并与健康对照组进行比较。
共纳入 30 例原发性 RLS/WED 患者和 30 例健康对照者。所有受试者均进行 RLS/WED 严重程度和睡眠问题评估。通过神经科检查和神经传导研究排除周围性多发性神经病。我们使用 Neurometer 系统进行 CPT 测试，用三种不同参数（2000 Hz、250 Hz 和 5 Hz）刺激两个大脚趾。CPT 测试分两次进行，一次在无症状的白天，另一次在患者出现症状的晚上。
RLS/WED 组和对照组的平均年龄分别为 50.5±11.7（22；73.3%为女性）和 46.3±11.4（24；80.0%为女性）。国际 RLS/WED 研究组严重程度量表评分为 28.6±4.25。白天，RLS/WED 患者和对照组的电流感知阈值无显著差异。然而，RLS/WED 患者在晚上三种刺激方案的平均 CPT 测量值均较低（2000 Hz：393.2±93.7 vs 430.8±79.6，250 Hz：172.0±48.4 vs 198.5±38.2，5 Hz：98.0±34.1 vs 124.6±31.3），而健康对照组则无差异。
RLS 患者晚上 CPT 较低。RLS/WED 患者痛觉过敏的昼夜变化表明存在中枢（昼夜节律）感觉处理障碍，而不是外周障碍。
