From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland.
Neurology. 2018 May 8;90(19):e1663-e1672. doi: 10.1212/WNL.0000000000005471. Epub 2018 Apr 11.
To define the prevalence, time course, and associated factors of periodic limb movements during sleep (PLMS) in patients with ischemic stroke or TIA.
Patients enrolled in the prospective Sleep-Disordered Breathing in Transient Ischemia Attack (TIA)/Ischemic Stroke and Continuous Positive Airway Pressure (CPAP) Treatment Efficacy (SAS-CARE) study underwent a double polysomnographic investigation in the acute and chronic phases after stroke/TIA, together with a MRI brain scan and a 24-hour blood pressure evaluation. The prevalence of PLMS in patients was compared with that in a matched sample of randomly selected healthy controls from the HypnoLaus cohort. One hundred sixty-nine recordings were performed in the acute phase and 191 after 3 months (210 recordings were obtained from the same 105 patients in both phases) and were compared to those of 162 controls.
The mean number of PLMS per hour and the percentage of participants with a PLMS index >10 and >15 per hour were similar between patients and controls. PLMS remained stable from the acute to the chronic phase after stroke. Factors positively associated with PLMS were age, body mass index, and history of hypertension. Blood pressure over 24 hours and the burden of cerebrovascular damage were similar between the groups with PLMS and without PLMS.
PLMS are equally frequent in patients with stroke/TIA and the general population. The absence of higher blood pressure values and of a greater vascular brain damage found in patients with PLMS compared to those without PLMS might be due to a greater use of antihypertensive medication among patients with PLMS, which corresponds to a higher prevalence of previous diagnosis of hypertension in these patients.
定义缺血性卒中和短暂性脑缺血发作（TIA）患者睡眠周期性肢体运动（PLMS）的患病率、时间进程和相关因素。
参加前瞻性睡眠障碍呼吸暂停在短暂性脑缺血发作（TIA）/缺血性卒中和持续气道正压通气（CPAP）治疗疗效（SAS-CARE）研究的患者在卒中/TIA 后的急性期和慢性期接受了两次双睡眠多导图检查，同时进行了 MRI 脑扫描和 24 小时血压评估。将患者的 PLMS 患病率与 HypnoLaus 队列中随机选择的健康对照组进行比较。在急性期进行了 169 次记录，在 3 个月后进行了 191 次记录（在两个阶段均从相同的 105 名患者中获得了 210 次记录），并与 162 名对照者进行了比较。
每小时 PLMS 的平均数量和每小时 PLMS 指数>10 和>15 的参与者百分比在患者和对照组之间相似。PLMS 从卒中的急性期到慢性期保持稳定。与 PLMS 相关的因素是年龄、体重指数和高血压病史。两组之间的 24 小时血压和脑血管损伤负担相似。
PLMS 在卒中/TIA 患者和普通人群中同样常见。与无 PLMS 的患者相比，PLMS 患者的血压值没有更高，且血管性脑损伤没有更严重，这可能是由于 PLMS 患者更常使用抗高血压药物，这与这些患者中高血压的先前诊断率更高相对应。
