Antelmi Elena, Ferri Raffaele, Provini Federica, Scaglione Cesa M L, Mignani Francesco, Rundo Francesco, Vandi Stefano, Fabbri Margherita, Pizza Fabio, Plazzi Giuseppe, Martinelli Paolo, Liguori Rocco
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
IRCCS Institute of Neurological Sciences, Bologna, Italy.
Sleep. 2017 Jul 1;40(7). doi: 10.1093/sleep/zsx088.
Impaired sleep has been reported as an important nonmotor feature in dystonia, but so far, self-reported complaints have never been compared with nocturnal video-polysomnographic (PSG) recording, which is the gold standard to assess sleep-related disorders.
Twenty patients with idiopathic isolated cervical dystonia and 22 healthy controls (HC) underwent extensive clinical investigations, neurological examination, and questionnaire screening for excessive daytime sleepiness and sleep-related disorders. A full-night video PSG was performed in both patients and HC. An ad hoc montage, adding electromyographic leads over the muscle affected with dystonia, was used.
When compared to controls, patients showed significantly increased pathological values on the scale assessing self-reported complaints of impaired nocturnal sleep. Higher scores of impaired nocturnal sleep did not correlate with any clinical descriptors but for a weak correlation with higher scores on the scale for depression. On video-PSG, patients had significantly affected sleep architecture (with decreased sleep efficiency and increased sleep latency). Activity over cervical muscles disappears during all the sleep stages, reaching significantly decreased values when compared to controls both in nonrapid eye movements and rapid eye movements sleep.
Patients with cervical dystonia reported poor sleep quality and showed impaired sleep architecture. These features however cannot be related to the persistence of muscle activity over the cervical muscles, which disappears in all the sleep stages, reaching significantly decreased values when compared to HC.
睡眠障碍已被报道为肌张力障碍的一项重要非运动特征，但迄今为止，自我报告的症状从未与夜间视频多导睡眠图（PSG）记录进行过比较，而PSG记录是评估睡眠相关障碍的金标准。
20例特发性孤立性颈部肌张力障碍患者和22名健康对照者（HC）接受了广泛的临床检查、神经系统检查以及针对日间过度嗜睡和睡眠相关障碍的问卷调查筛选。患者和HC均进行了整夜视频PSG检查。采用了一种特殊的导联设置，在受肌张力障碍影响的肌肉上增加了肌电图导联。
与对照组相比，患者在评估夜间睡眠障碍自我报告症状的量表上病理值显著升高。夜间睡眠障碍得分较高与任何临床指标均无相关性，但与抑郁量表得分较高存在微弱相关性。在视频PSG检查中，患者的睡眠结构受到显著影响（睡眠效率降低，睡眠潜伏期延长）。在所有睡眠阶段，颈部肌肉的活动均消失，与对照组相比，在非快速眼动睡眠和快速眼动睡眠中均显著降低。
颈部肌张力障碍患者报告睡眠质量差，且睡眠结构受损。然而，这些特征与颈部肌肉活动的持续存在无关，颈部肌肉活动在所有睡眠阶段均消失，与HC相比显著降低。
