Boulos Mark I, Wan Anthony, Black Sandra E, Lim Andrew S, Swartz Richard H, Murray Brian J
L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada; Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Sleep Med. 2017 Sep;37:135-140. doi: 10.1016/j.sleep.2017.05.020. Epub 2017 Jun 30.
Restless legs syndrome (RLS) is a movement disorder that is associated with poor quality of life and depressive symptoms in the general population. Emerging evidence suggests that RLS is closely associated with cerebrovascular disease. We assessed the effect of RLS on quality of life after stroke and transient ischemic attack (TIA).
In this single-center prospective study, we recruited patients within 14 days of high-risk TIA or minor stroke. Patients were diagnosed with RLS using a questionnaire based on the 2003 International RLS Study Group criteria, and diagnoses were confirmed by a sleep neurologist. Follow-up assessments were conducted within 2-6 months of recruitment. The outcome of quality of life was measured using the Stroke-specific Quality of Life (SS-QoL).
Of the 94 patients recruited into the study, 23 (24.4%) were diagnosed with RLS: 11 were newly diagnosed with RLS and 12 had RLS preceding the index stroke/TIA. There were no significant differences in baseline characteristics between those with or without RLS. Median SS-QoL in patients with RLS was lower at baseline (p = 0.008) and at follow-up (p = 0.002). RLS patients had more depressive symptoms at follow-up (p = 0.007). Ordinal logistic regression demonstrated that RLS was negatively associated with quality of life at baseline (OR = 0.28; p = 0.010) and at follow-up (OR = 0.14; p = 0.029), independent of functional outcome and depressive symptoms.
RLS is common after stroke or TIA and negatively affects the quality of life. Screening for RLS after cerebrovascular events may be warranted, and future research should assess whether treatment of RLS can improve post-stroke quality of life.
不宁腿综合征（RLS）是一种运动障碍，与普通人群的生活质量差和抑郁症状相关。新出现的证据表明，RLS与脑血管疾病密切相关。我们评估了RLS对中风和短暂性脑缺血发作（TIA）后生活质量的影响。
在这项单中心前瞻性研究中，我们招募了高危TIA或轻度中风后14天内的患者。根据2003年国际RLS研究组标准，使用问卷对患者进行RLS诊断，并由睡眠神经科医生确诊。在招募后2至6个月内进行随访评估。使用卒中特异性生活质量（SS-QoL）量表测量生活质量结果。
在纳入研究的94例患者中，23例（24.4%）被诊断为RLS：11例为新诊断的RLS，12例在首次中风/TIA之前就患有RLS。有或没有RLS的患者在基线特征上没有显著差异。RLS患者的SS-QoL中位数在基线时较低（p = 0.008），在随访时也较低（p = 0.002）。RLS患者在随访时抑郁症状更多（p = 0.007）。有序逻辑回归显示，RLS与基线时的生活质量呈负相关（OR = 0.28；p = 0.010），在随访时也是如此（OR = 0.14；p = 0.029），且独立于功能结局和抑郁症状。
RLS在中风或TIA后很常见，并对生活质量产生负面影响。脑血管事件后筛查RLS可能是必要的，未来的研究应评估RLS的治疗是否能改善中风后的生活质量。
