Impaired Sensorimotor Integration in Restless Legs Syndrome.
Impaired Sensorimotor Integration in Restless Legs Syndrome.
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DOI：
10.3389/fneur.2018.00568
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发表时间：
2018
影响因子：
3.4
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Lin Y;Wang Y;Zhan S;Ding Y;Hou Y;Wang L;Wang Y
目的：不宁腿综合征（RLS）是一种复杂的感觉运动综合征，可能与感觉运动整合的改变有关。这种变化的机制尚不清楚。本研究旨在通过外周电刺激的经颅磁刺激-运动诱发电位（TMS-MEPs）研究RLS患者的感觉运动整合。方法：对14例RLS患者和12例年龄匹配的健康对照进行调查。根据国际不宁腿综合征研究组的国际标准（IRLSSG）严重程度评分评估RLS的临床严重程度。对26例受试者进行胫骨反射、中位h反射和短拇外展肌静息运动阈值（RMT）测试。对8例患者和7例对照组进行了胫骨前肌（TA）的RMT测试。所有26名受试者均测量了APB的无条件mep。电脉冲作用于右侧正中神经，然后在20、25、30、50、100、150和200 ms的刺激间隔（ISIs）对左侧运动皮层施加TMS脉冲。在8例患者和7例对照组中测量TA的非条件MEPs。在30、35、45、60、100和200 ms的时间点，分别在右侧腓神经施加电脉冲，然后在左侧运动皮层施加TMS脉冲。电刺激对MEP的调制程度表示为条件MEP振幅与非条件MEP振幅之比。比值<1表示抑制，比值>1表示促进。结果：RLS患者与对照组在RMT或h反射潜伏期或振幅上无显著差异。与对照组相比，观察到患者TA的无条件MEP振幅显著增加（p = 0.03）。RLS患者正中神经长潜伏期传入抑制（LAI）在ISIs为150 （p = 0.000）和200 ms时显著降低（p = 0.004）。腓神经刺激后，两组间ISI均无显著差异。结论：我们的研究结果表明，RLS患者的腿部运动皮质兴奋性增加，感觉运动整合障碍；这种紊乱可能起源于皮层水平。
Objective: Restless legs syndrome (RLS) is a complicated sensorimotor syndrome that may be linked to changes in sensorimotor integration. The mechanism of such changes is unclear. The aim of this study was to investigate sensorimotor integration in patients with RLS through transcranial magnetic stimulation-motor evoked potentials (TMS-MEPs) preceded by peripheral electric stimulation. Methods: Fourteen RLS patients and 12 healthy, age-matched controls were investigated. The clinical severity of RLS was evaluated based on the International Criteria of the International Restless Legs Syndrome Study Group (IRLSSG) severity scores. The tibial and median H-reflexes and the resting motor threshold (RMT) of the abductor pollicis brevis (APB) were tested in all 26 subjects. The RMT of the tibialis anterior (TA) was tested in 8 patients and 7 controls. All 26 subjects underwent measurement of unconditioned MEPs of the APB. Electric pulses were applied to the right median nerve, followed by TMS pulses over the left motor cortex at interstimulus intervals (ISIs) of 20, 25, 30, 50, 100, 150, and 200 ms. Unconditioned MEPs of the TA were measured in 8 patients and 7 controls. Electric pulses were applied to the right peroneal nerve, followed by TMS pulses over the left motor cortex at ISIs of 30, 35, 45, 60, 100, and 200 ms. The degree of modulation of MEPs by electric stimulation was expressed as the ratio of the conditioned MEP amplitude to the unconditioned MEP amplitude. Ratios <1 indicated inhibition, and ratios >1 indicated facilitation. Results: No significant differences in RMT or H-reflex latencies or amplitudes were found between RLS patients and controls. A significant increase in unconditioned MEP amplitudes of the TA was observed in patients compared to controls (p = 0.03). Long-latency afferent inhibition (LAI) of the median nerve in RLS patients was decreased significantly at ISIs of 150 (p = 0.000) and 200 ms (p = 0.004). Upon peroneal nerve stimulation, no significant difference was observed between the two groups at any ISI. Conclusions: Our results suggest increased motor cortical excitability of the legs and disturbed sensorimotor integration in RLS patients; this disturbance might originate at the cortical level.
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影响因子：
5.7
作者：
Etgen, T;Draganski, B;May, A
通讯作者：
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影响因子：
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作者：
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