Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Network for Narcolepsy, CHU Montpellier, France.
Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Network for Narcolepsy, CHU Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
Sleep Med. 2021 Apr;80:30-38. doi: 10.1016/j.sleep.2021.01.017. Epub 2021 Jan 18.
To compare the clinical features of autonomic dysfunction using the SCOPA-AUT questionnaire in untreated patients with restless legs syndrome (RLS) with controls, to identify factors associated with more severe autonomic symptoms, and to assess the effect of medication in patients.
The SCOPA-AUT questionnaire that evaluates cardiovascular, gastrointestinal, urinary, thermoregulatory, pupillomotor, and sexual dysfunctions was completed by 409 consecutive untreated patients with RLS (54.1 ± 14.5 y.o; 265 women) and 331 controls (59.0 ± 17.0; 161 women). Clinical and polysomnographic data were assessed in all patients. A subgroup of 57 patients were evaluated a second time after treatment (mostly dopaminergic agonist) after an interval of 0.88 ± 1.42 year.
Compared to controls, untreated patients with RLS were younger, more often women, obese, with increased cardiovascular diseases (CVD). The SCOPA-AUT total score was higher in patients than controls in unadjusted and adjusted models. Patients had more autonomic symptoms in all subdomains of the scale (except for sexual dysfunction in men). These results were confirmed in a subgroup of 259 cases and age-sex-matched controls. Female gender, obesity, RLS severity, diabetes mellitus, CVD, sleepiness, insomnia and depressive symptoms but neither periodic legs movements during sleep (PLMS) nor objective sleep parameters were associated with high scores. Despite RLS and PLMS improvement, medication did not change total and subdomain scores.
Patients with RLS have frequent and large spectrum of autonomic symptoms, without effect of PLMS, sleep fragmentation and medication. These results suggest a global autonomic dysfunction in RLS that should be assessed more systematically in severe patients.
使用自主神经功能障碍问卷（SCOPA-AUT）比较未经治疗的不安腿综合征（RLS）患者与对照组之间自主神经功能障碍的临床特征，确定与更严重自主症状相关的因素，并评估药物治疗对患者的影响。
完成了 409 例未经治疗的 RLS 患者（54.1±14.5 岁；265 名女性）和 331 例对照组（59.0±17.0 岁；161 名女性）的 SCOPA-AUT 问卷，该问卷评估心血管、胃肠道、泌尿、体温调节、瞳孔运动和性功能障碍。所有患者均进行了临床和多导睡眠图评估。57 例患者在间隔 0.88±1.42 年后（主要为多巴胺激动剂）接受了第二次治疗评估。
与对照组相比，未经治疗的 RLS 患者年龄较小，女性居多，肥胖，心血管疾病（CVD）更多。未经调整和调整模型中，患者的 SCOPA-AUT 总分均高于对照组。与对照组相比，患者在量表的所有子领域都有更多的自主症状（男性性功能障碍除外）。在亚组 259 例病例和年龄性别匹配的对照组中得到了证实。女性、肥胖、RLS 严重程度、糖尿病、CVD、嗜睡、失眠和抑郁症状与高分相关，但周期性肢体运动（PLMS）和客观睡眠参数均不相关。尽管 RLS 和 PLMS 有所改善，但药物治疗并未改变总分和子领域评分。
RLS 患者自主症状频繁且广泛，但 PLMS、睡眠碎片化和药物治疗无影响。这些结果表明 RLS 存在全身性自主神经功能障碍，应在严重患者中更系统地评估。
