Droste D W, Krauss J K, Hagedorn G, Kaps M
Department of Neurology, Medical University of Lübeck, Germany.
Acta Neurol Scand. 1996 Nov;94(5):347-52. doi: 10.1111/j.1600-0404.1996.tb07078.x.
Periodic leg movements (PLM) in sleep are supposed to constitute a frequent cause of insomnia. There is some controversy whether PLM are the cause of insomnia by provoking microarousals or whether they are simply and epiphenomenon not casually related to the insomnia. We examined four patients with PLM by overnight polysomnography and concomitant transcranial Doppler sonography (TCD) monitoring, 13 patients with suspected normal pressure hydrocephalus by concomitant overnight polysomnography and intracranial pressure recording, and 10 healthy volunteers by concomitant overnight polysomnography and TCD monitoring. EEG arousals occurred more frequently before than after the PLM. PLM were associated with increase in heart rate, breathing amplitude, and cerebral blood flow velocity assessed by TCD. PLM occurred with a mean wavelength of 40.5 s. This mean wavelength corresponded to similar values calculated for intracranial pressure B-waves (43.3 s) in 13 patients with suspected normal-pressure hydrocephalus, TCD B-wave equivalents (42.2 s) in 10 healthy young adults and the frequency of the cyclic alternating pattern in EEg recordings (40 s). Our date suggest that these cyclic variations with a wavelength of about 40 s are part of a common endogenous rhythm. PLM seem to be an epiphenomenon of this rhythm and not the cause of insomnia.
睡眠中的周期性腿部运动（PLM）被认为是失眠的常见原因。关于PLM是通过引发微觉醒导致失眠，还是仅仅是与失眠偶然无关的一种附带现象，存在一些争议。我们通过夜间多导睡眠图和同步经颅多普勒超声（TCD）监测检查了4例PLM患者，通过同步夜间多导睡眠图和颅内压记录检查了13例疑似正常压力脑积水患者，通过同步夜间多导睡眠图和TCD监测检查了10名健康志愿者。脑电图觉醒在PLM之前比之后更频繁地发生。PLM与通过TCD评估的心率、呼吸幅度和脑血流速度增加有关。PLM出现的平均波长为40.5秒。这个平均波长与13例疑似正常压力脑积水患者颅内压B波计算出的类似值（43.3秒）、10名健康年轻人的TCD B波等效值（42.2秒）以及脑电图记录中周期性交替模式的频率（40秒）相对应。我们的数据表明，这些波长约为40秒的周期性变化是一种常见内源性节律的一部分。PLM似乎是这种节律的一种附带现象，而不是失眠的原因。
