OBJECTIVE: To assess the frequency of periodic leg movements (PLM) in idiopathic REM sleep behavior disorder (RBD) and to analyze their polysomnographic characteristics and associated autonomic and cortical activation. BACKGROUND:PLM during sleep (PLMS) and wakefulness (PLMW) are typical features of restless legs syndrome (RLS), but are also frequently observed in patients with RBD. METHODS:Forty patients with idiopathic RBD underwent one night of polysomnographic recording to assess PLMS frequency. PLM features, PLMS-related cardiac activation during stage 2 sleep, and EEG changes were analyzed in 15 of these patients with RBD. Results were compared with similar data obtained in 15 sex- and age-matched patients with primary RLS. RESULTS: Twenty-eight (70%) of 40 patients with RBD showed a PLMS index greater than 10. No between-group differences were found in sleep architecture or indexes of PLMW and PLMS during non-REM sleep, but a trend for a higher PLMS index during REM sleep was found in patients with RBD. PLM mean duration and interval in the two conditions were similar. A transient tachycardia followed by a bradycardia was observed in close association with every PLMS in both groups, but the amplitude of the cardiac activation was significantly reduced in patients with RBD. In addition, significantly fewer PLMS were associated with microarousal in this condition. CONCLUSIONS: Periodic leg movements are very common in idiopathic RBD, occurring in all stages of sleep, especially during REM sleep. In idiopathic RBD, the reduction of cardiac and EEG activation associated with PLMS suggests the presence of an impaired autonomic and cortical reactivity to internal stimuli.
RCT Entities:
OBJECTIVE: To assess the frequency of periodic leg movements (PLM) in idiopathic REM sleep behavior disorder (RBD) and to analyze their polysomnographic characteristics and associated autonomic and cortical activation. BACKGROUND: PLM during sleep (PLMS) and wakefulness (PLMW) are typical features of restless legs syndrome (RLS), but are also frequently observed in patients with RBD. METHODS: Forty patients with idiopathic RBD underwent one night of polysomnographic recording to assess PLMS frequency. PLM features, PLMS-related cardiac activation during stage 2 sleep, and EEG changes were analyzed in 15 of these patients with RBD. Results were compared with similar data obtained in 15 sex- and age-matched patients with primary RLS. RESULTS: Twenty-eight (70%) of 40 patients with RBD showed a PLMS index greater than 10. No between-group differences were found in sleep architecture or indexes of PLMW and PLMS during non-REM sleep, but a trend for a higher PLMS index during REM sleep was found in patients with RBD. PLM mean duration and interval in the two conditions were similar. A transient tachycardia followed by a bradycardia was observed in close association with every PLMS in both groups, but the amplitude of the cardiac activation was significantly reduced in patients with RBD. In addition, significantly fewer PLMS were associated with microarousal in this condition. CONCLUSIONS: Periodic leg movements are very common in idiopathic RBD, occurring in all stages of sleep, especially during REM sleep. In idiopathic RBD, the reduction of cardiac and EEG activation associated with PLMS suggests the presence of an impaired autonomic and cortical reactivity to internal stimuli.
Authors: Luigi Ferini-Strambi; Wolfgang Oertel; Yves Dauvilliers; Ronald B Postuma; Sara Marelli; Alex Iranzo; Isabelle Arnulf; Birgit Högl; Högl Birgit; Raffaele Manni; Tomoyuki Miyamoto; Maria-Livia Fantini; Monica Puligheddu; Poul Jennum; Karel Sonka; Joan Santamaria; Marco Zucconi; Paola M V Rancoita; Smeranda Leu-Semenescu; Birgit Frauscher; Michele Terzaghi; Masayuki Miyamoto; Marcus Unger; Karin Stiasny-Kolster; Alex Desautels; Christina Wolfson; Amélie Pelletier; Jacques Montplaisir Journal: J Neurol Date: 2014-04-01 Impact factor: 4.849
Authors: R Nisha Aurora; Rochelle S Zak; Rama K Maganti; Sanford H Auerbach; Kenneth R Casey; Susmita Chowdhuri; Anoop Karippot; Kannan Ramar; David A Kristo; Timothy I Morgenthaler Journal: J Clin Sleep Med Date: 2010-02-15 Impact factor: 4.062