Wang Xi-Xi, Liu Ye, Song Jia-Min, Zhang Yu-Lei, Wang Yu, William Ondo G, Feng Ya, Wu Yun-Cheng
Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurology, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China.
Sleep Med. 2025 May;129:75-81. doi: 10.1016/j.sleep.2025.02.030. Epub 2025 Feb 20.
Recent studies suggest that stroke may be associated with an increased prevalence of restless legs syndrome (RLS) as a comorbidity or a risk factor. We aimed to explore the association between acute ischemic stroke (AIS) and RLS, and the possible pathogenesis of acute ischemic stroke related restless legs syndrome (AIS-RLS), for guiding its diagnosis and treatment.
In this single-center, prospective study, we identified consecutive AIS patients and segregated into AIS-RLS group and non-AIS-RLS group based on the diagnostic criteria of RLS. The differences in baseline data, clinical features, examination results, stroke etiology, stroke location, and clinical prognosis (functional disability, cognitive and mood disorders) of the two groups were analyzed. Logistic regression analysis was used to evaluate the risk factors for RLS.
A total of 201 AIS patients were included in our study, and 21 (10.45 %) demonstrated RLS. Compared with non-AIS-RLS group, AIS-RLS group patients had higher systolic blood pressure (SBP) at admission (P < 0.05), higher mean 24-h SBP (P < 0.01), higher mean 24-h diastolic blood pressure (DBP) (P < 0.01), higher mean daytime SBP (P < 0.01), higher mean daytime DBP (P < 0.01), higher mean nocturnal SBP (P < 0.01), higher mean nocturnal DBP (P < 0.05), smaller variation coefficient of 24-h SBP (P < 0.05). The distribution of AIS-RLS and non-AIS-RLS was not different for each subtype according to the cortical and subcortical classification of lesion sites. The NIHSS score, GAD-7 score and PHQ-9 score were higher at 7 days (P < 0.05), and the modified Rankin scale (mRS) was higher at 3 months follow-up (P < 0.05) in the AIS-RLS group. In the logistic regression, the higher SBP at admission had a statistically significant effect on AIS-RLS(OR = 1.030,P = 0.016)even after adjusting for age and gender(OR = 1.030,P = 0.014).
Stroke anatomy did not differ between AIS-RLS and non-AIS-RLS groups. AIS-RLS group patients tend to experience higher blood pressure. Moreover, AIS-RLS patients had worse clinical prognosis (functional disability and mood disorders) compared with non-AIS-RLS patients.
近期研究表明，中风可能与不安腿综合征（RLS）作为一种合并症或危险因素的患病率增加有关。我们旨在探讨急性缺血性中风（AIS）与RLS之间的关联，以及急性缺血性中风相关不安腿综合征（AIS-RLS）的可能发病机制，以指导其诊断和治疗。
在这项单中心前瞻性研究中，我们纳入了连续的AIS患者，并根据RLS的诊断标准将其分为AIS-RLS组和非AIS-RLS组。分析了两组患者的基线数据、临床特征、检查结果、中风病因、中风部位和临床预后（功能残疾、认知和情绪障碍）的差异。采用逻辑回归分析评估RLS的危险因素。
我们的研究共纳入201例AIS患者，其中21例（10.45%）表现出RLS。与非AIS-RLS组相比，AIS-RLS组患者入院时收缩压（SBP）更高（P<0.05），24小时平均SBP更高（P<0.01），24小时平均舒张压（DBP）更高（P<0.01），日间平均SBP更高（P<0.01），日间平均DBP更高（P<0.01），夜间平均SBP更高（P<0.01），夜间平均DBP更高（P<0.05），24小时SBP变异系数更小（P<0.05）。根据病变部位的皮质和皮质下分类，各亚型的AIS-RLS和非AIS-RLS分布无差异。AIS-RLS组在第7天时美国国立卫生研究院卒中量表（NIHSS）评分、广泛性焦虑量表（GAD-7）评分和患者健康问卷-9（PHQ-9）评分更高（P<0.05），在3个月随访时改良Rankin量表（mRS）评分更高（P<0.05）。在逻辑回归中，即使在调整年龄和性别后，入院时较高的SBP对AIS-RLS仍有统计学显著影响（OR=1.030，P=0.016；OR=1.030，P=
