不宁腿综合征（restless legs syndrome，RLS）和周期性肢体运动（periodic limb movement，PLM）同属临床上常见的睡眠障碍性疾患，其临床症状相似，以休息时下肢出现感觉异常，夜间症状明显，活动后症状暂时缓解为主要表现，这两种疾...不宁腿综合征（restless legs syndrome，RLS）和周期性肢体运动（periodic limb movement，PLM）同属临床上常见的睡眠障碍性疾患，其临床症状相似，以休息时下肢出现感觉异常，夜间症状明显，活动后症状暂时缓解为主要表现，这两种疾病临床上极为容易误诊、漏诊。现综述如下。展开更多
Restless legs syndrome (RLS), a sensorimotor disorder characterized by unpleasant sensations commonly localized in the legs, is frequently associated with periodic limb movements (PLMs) during sleep. We investigated t...Restless legs syndrome (RLS), a sensorimotor disorder characterized by unpleasant sensations commonly localized in the legs, is frequently associated with periodic limb movements (PLMs) during sleep. We investigated the role of transcranial magnetic stimulation (TMS) and cortical silent period (CSP)duration as diagnostic and monitoring tools in 20 patients with primary RLS before and after 1 month of treatment and also studied 15 normal age-and gender-matched subjects. Polysomnographic assessment was undertaken and the PLM index determined in 17 of the 20 patients. We also studied the correlation between sleep efficiency index and CSP duration because of the increasing severity of the sleep disturbance and PLMs in patients with RLS. Our results demonstrate that the duration of the CSP was reduced in patients with RLS, and that dopaminergic treatment normalized this duration. There was no correlation between the PLM index and CSP duration. It may be speculated that PLMs and the CSP are due to different inhibitory mechanisms and they may be used separately as diagnostic and monitoring tools in patients with primary RLS.展开更多
文摘目的:考察选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)与抑郁患者的周期性肢体运动综合征(periodic limb movement syndrome,PLMS)的关系。方法:本研究是病例回顾性分析,来自广东省精神卫生研究所的多导睡眠图(polysomnography,PSG)数据库(2006年11月-2009年11月)。选择了31例接受SSRI治疗的抑郁患者组(治疗组),并设定了2个对照组:27例未接受药物治疗抑郁患者组(未治疗组)和31例正常对照组。根据2007版美国睡眠研究会标准,判定了睡眠分期、睡眠相关事件和PLMS。结果:SSRI治疗组(13.7±2.6)比未治疗组(5.3±1.4)和正常对照组(4.1±1.1)的周期性肢体运动指数(periodic limb movement index,PLMI)更高(F=10.373,P<0.001),而且治疗组的PLMS发生率(41.9%)明显高于其他两组(未治疗组:11.1%,正常对照组:6.5%,χ2=10.227,P<0.001)。logistic回归显示的SSRI剂量越高(OR=1.107,1.036～1.184)、REM潜伏期越长(OR=1.289,1.176～1.413)和微觉醒越多(OR=1.483,1.219～1.748),接受SSRI的被治疗者就越容易出现PLMS。结论:选择性5-羟色胺再摄取抑制剂可能增加了抑郁患者出现周期性肢体运动综合征的风险,是一个值得临床学家重视的药源性副反应。
文摘不宁腿综合征（restless legs syndrome，RLS）和周期性肢体运动（periodic limb movement，PLM）同属临床上常见的睡眠障碍性疾患，其临床症状相似，以休息时下肢出现感觉异常，夜间症状明显，活动后症状暂时缓解为主要表现，这两种疾病临床上极为容易误诊、漏诊。现综述如下。
文摘Restless legs syndrome (RLS), a sensorimotor disorder characterized by unpleasant sensations commonly localized in the legs, is frequently associated with periodic limb movements (PLMs) during sleep. We investigated the role of transcranial magnetic stimulation (TMS) and cortical silent period (CSP)duration as diagnostic and monitoring tools in 20 patients with primary RLS before and after 1 month of treatment and also studied 15 normal age-and gender-matched subjects. Polysomnographic assessment was undertaken and the PLM index determined in 17 of the 20 patients. We also studied the correlation between sleep efficiency index and CSP duration because of the increasing severity of the sleep disturbance and PLMs in patients with RLS. Our results demonstrate that the duration of the CSP was reduced in patients with RLS, and that dopaminergic treatment normalized this duration. There was no correlation between the PLM index and CSP duration. It may be speculated that PLMs and the CSP are due to different inhibitory mechanisms and they may be used separately as diagnostic and monitoring tools in patients with primary RLS.
