Cederberg Katie L J, Jeng Brenda, Sasaki Jeffer E, Motl Robert W
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL USA.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL USA.
Mult Scler Relat Disord. 2020 Aug;43:102176. doi: 10.1016/j.msard.2020.102176. Epub 2020 May 18.
Restless Legs Syndrome (RLS) is a prominent sleep disorder that often worsens sleep quality and perhaps cognitive function in adults with multiple sclerosis (MS). The present study examined the relationships among RLS prevalence and severity, sleep quality, and perceived cognitive impairment in adults with MS.
Participants (N=275) completed the Cambridge-Hopkins Restless Legs Syndrome Questionnaire, the International Restless Legs Syndrome Study Group (IRLS) Scale, the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), the Pittsburgh Sleep Quality Index (PSQI), the Patient Determined Disease Steps (PDDS), and a demographic and clinical characteristics questionnaire.
Persons with MS who had RLS (i.e., MS+RLS; n=74) reported significantly worse perceived cognitive impairment compared with those who did not have RLS (n=201; p=0.015). Bivariate correlation analyses within the MS+RLS group indicated that greater RLS severity was significantly associated with more severe perceived cognitive impairment (r=0.274) and sleep quality (r=0.380), and worse perceived cognitive impairment was significantly associated with worse sleep quality (r=0.438). Linear, step-wise regression analyses indicated that RLS severity significantly predicted perceived cognitive impairment (β=0.274), but the inclusion of sleep quality (β=0.391) accounted for the relationship between RLS severity and perceived cognitive impairment (β=0.126).
Our results suggest that sleep impairment may be an intermediary factor in the association between RLS severity and cognitive impairment in persons with MS who present with RLS. The diagnosis and treatment of RLS symptoms and other effectors of sleep quality could improve neuropsychological consequences of MS.
不宁腿综合征（RLS）是一种常见的睡眠障碍，常使多发性硬化症（MS）成人患者的睡眠质量恶化，甚至可能影响其认知功能。本研究探讨了MS成人患者中RLS患病率、严重程度、睡眠质量和认知功能损害之间的关系。
参与者（N = 275）完成了剑桥-霍普金斯不宁腿综合征问卷、国际不宁腿综合征研究组（IRLS）量表、多发性硬化症神经心理学筛查问卷（MSNQ）、匹兹堡睡眠质量指数（PSQI）、患者确定的疾病阶段（PDDS）以及一份人口统计学和临床特征问卷。
患有RLS的MS患者（即MS + RLS；n = 74）与未患RLS的患者（n = 201；p = 0.015）相比，认知功能损害更严重。MS + RLS组的双变量相关分析表明，RLS严重程度越高，认知功能损害越严重（r = 0.274），睡眠质量越差（r = 0.380），认知功能损害越严重，睡眠质量越差（r = 0.438）。线性逐步回归分析表明，RLS严重程度显著预测认知功能损害（β = 0.274），但纳入睡眠质量（β = 0.391）后，可解释RLS严重程度与认知功能损害之间的关系（β = 0.126）。
我们的结果表明，睡眠障碍可能是伴有RLS的MS患者中RLS严重程度与认知障碍之间关联的中介因素。RLS症状及其他睡眠质量影响因素的诊断和治疗可能会改善MS的神经心理学后果。
