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多发性硬化症的夜间睡眠研究:与临床及脑磁共振成像结果的相关性

Nocturnal sleep study in multiple sclerosis: correlations with clinical and brain magnetic resonance imaging findings.

作者信息

Ferini-Strambi L, Filippi M, Martinelli V, Oldani A, Rovaris M, Zucconi M, Comi G, Smirne S

机构信息

Sleep Disorders Center, State University, Milan, Italy.

出版信息

J Neurol Sci. 1994 Sep;125(2):194-7. doi: 10.1016/0022-510x(94)90035-3.

Abstract

It has been suggested that sleep disturbances in multiple sclerosis (MS) may be related to periodic leg movements (PLM) during sleep, but to date polysomnographic studies were conducted only on small and unselected patient groups. Aim of this study was to evaluate 8-hour polysomnography in MS patients and to correlate sleep results with clinical and brain magnetic resonance imaging (MRI) data. Twenty-five clinically definite MS patients, without mood disorders and drug-free, entered the study. The patients were compared to 25 age- and sex-matched subjects. MS patients had significantly reduced sleep efficiency and experienced more awakenings during sleep. No difference was found in sleep architecture parameters between MS patients and controls. PLM was found in 9 patients (36%) and 2 controls (8%; p = 0.02). Of the six patients who complained of insomnia two had PLM and 2 others presented with PLM and central sleep apnea. In patients with PLM greater MRI lesion loads were detected in the infratentorial regions, particularly in cerebellum and brainstem. Larger studies in neurological diseases that produce focal lesions in these brain areas could provide useful information on the PLM pathogenesis.

摘要

有人认为,多发性硬化症(MS)患者的睡眠障碍可能与睡眠期间的周期性腿部运动(PLM)有关,但迄今为止,多导睡眠图研究仅在小型且未经筛选的患者群体中进行。本研究的目的是评估MS患者的8小时多导睡眠图,并将睡眠结果与临床及脑磁共振成像(MRI)数据相关联。25例无情绪障碍且未服用药物的临床确诊MS患者进入本研究。将这些患者与25名年龄和性别匹配的受试者进行比较。MS患者的睡眠效率显著降低,睡眠期间觉醒次数更多。MS患者与对照组在睡眠结构参数方面未发现差异。9例患者(36%)和2名对照者(8%;p = 0.02)出现PLM。在6例主诉失眠的患者中,2例有PLM,另外2例同时出现PLM和中枢性睡眠呼吸暂停。在有PLM的患者中,幕下区域,尤其是小脑和脑干检测到更大的MRI病变负荷。对在这些脑区产生局灶性病变的神经疾病进行更大规模的研究,可能会为PLM的发病机制提供有用信息。

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