Why the worsening at rest and worsening at night criteria for Restless Legs Syndrome are listed separately: review of the circadian literature on RLS and suggestions for future directions.
Why the worsening at rest and worsening at night criteria for Restless Legs Syndrome are listed separately: review of the circadian literature on RLS and suggestions for future directions.
复制标题
DOI：
10.3389/fneur.2023.1153273
复制
发表时间：
2023
影响因子：
3.4
通讯作者：
Zee, Phyllis C.
中科院分区：
文献类型：
--
作者：
Walters, Arthur S.;Zee, Phyllis C.
关键词：
综述了不宁腿综合征（RLS）和周期性肢体运动（PLMs）的昼夜节律研究领域。RLS有五个强制性诊断标准：（1）经常伴有不舒服的腿部感觉的移动腿部的冲动;（2）休息时症状更严重，即，躺着或坐着;（3）通过活动至少部分和暂时缓解症状，例如，行走或伸展或弯曲腿;（4）症状在白天晚些时候或晚上更严重;和（5）RLS的模拟，如腿抽筋和位置不适，应通过病史和体格检查排除。此外，RLS经常伴有PLM，如通过多导睡眠图确定的睡眠周期性肢体运动（PLMS）或如通过建议的固定试验（SIT）确定的清醒时周期性肢体运动（PLMW）。由于RLS的标准仅基于临床经验，因此标准制定后的早期问题是标准2和4是相同还是不同的现象。换句话说，RLS患者在夜间病情恶化仅仅是因为他们躺着，而RLS患者躺着病情恶化仅仅是因为是晚上吗？早期的昼夜节律研究表明，不舒服的感觉，PLMS和PLMW以及对腿部不适的自主运动遵循类似的昼夜节律模式，在夜间恶化，与体位无关，也与睡眠时间或持续时间无关。其他研究表明，RLS患者在坐着或躺下时会变得更糟，与一天中的时间无关。这些研究作为一个整体表明，RLS的休息时恶化和夜间恶化标准是相关的，但是不同的现象，RLS的标准2和4应根据昼夜节律研究分开，就像以前仅根据临床理由的情况一样。为了更充分地证明RLS的昼夜节律性，应该进行研究，看看明亮的光线是否会将RLS的体征和症状转移到与昼夜节律标记一致的不同昼夜节律时间。
The field of circadian research on Restless Legs Syndrome (RLS) and periodic limb movements (PLMs) is reviewed in general. RLS has five obligatory criteria for diagnosis: (1) an urge to move the legs often accompanied by uncomfortable leg sensations; (2) symptoms are worse at rest, i.e., lying or sitting; (3) there is a least partial and temporary relief of symptoms by activity, e.g., walking or stretching or bending the legs; (4) symptoms are worse later in the day or at night; and (5) mimics of RLS such as leg cramps and positional discomfort should be excluded by history and physical. In addition, RLS is frequently accompanied by PLMs, either periodic limb movements of sleep (PLMS) as determined by polysomnography or periodic limb movements while awake (PLMW) as determined by the suggested immobilization test (SIT). Since the criteria for RLS were based upon clinical experience only, an early question after the development of the criteria was whether criteria 2 and 4 were the same or different phenomena. In other words, were RLS patients worse at night only because they were lying down, and were RLS patients worse lying down only because it was night? Early circadian studies performed during recumbency at different times of the day suggest that the uncomfortable sensations, PLMS, and PLMW as well as voluntary movement in response to leg discomfort follow a similar circadian pattern with worsening at night independent of body position and independent of sleep timing or duration. Other studies demonstrated that RLS patients get worse when sitting or lying down independent of the time of day. These studies as a whole suggest that the worsening at rest and the worsening at night criteria for RLS are related but separate phenomena and that criteria 2 and 4 for RLS should be kept separate based upon the circadian studies, as had been the case previously based upon clinical grounds alone. To more fully prove the circadian rhythmicity of RLS, studies should be conducted to see if bright light shifts the signs and symptoms of RLS to a different circadian time in concert with circadian markers.
登录
查看更多内容
影响因子：
4.8
作者：
Garcia-Borreguero, D;Serrano, C;Granizo, JJ
通讯作者：
Granizo, JJ
影响因子：
4.8
作者：
Earley, Christopher J.;Hyland, Keith;Allen, Richard P.
通讯作者：
Allen, Richard P.
影响因子：
4.8
作者：
Cho, Yong Won;Kang, Min-Sung;Motamedi, Gholam K.
通讯作者：
Motamedi, Gholam K.
影响因子：
2.5
作者：
Dafkin, Chloe;Green, Andrew;Kerr, Samantha
通讯作者：
Kerr, Samantha
影响因子：
4.8
作者：
Duffy, Jeanne F.;Lowe, Alex S. W.;Winkelman, John W.
通讯作者：
Winkelman, John W.