Pain and the Alpha-Sleep Anomaly: A Mechanism of Sleep Disruption in Facioscapulohumeral Muscular Dystrophy
Pain and the Alpha-Sleep Anomaly: A Mechanism of Sleep Disruption in Facioscapulohumeral Muscular Dystrophy
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DOI：
10.1111/pme.12054
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发表时间：
2013-04-01
期刊：
影响因子：
3.1
通讯作者：
Ricci, Enzo
中科院分区：
文献类型：
--
作者：
Della Marca, Giacomo;Frusciante, Roberto;Ricci, Enzo
目的探讨面肩肱骨肌营养不良（FSHD）患者睡眠异常的存在，并探讨睡眠脑电图（EEG）模式与肌肉骨骼疼痛的关系。设计横断面研究。设置睡眠实验室。55例连续的成年FSHD患者，女性26例，男性29例，年龄49.6±15.1岁（范围1876）。干预问卷和多导睡眠描记术。结果测量患者被要求说明在睡眠研究前3个月是否出现持续或复发的肌肉骨骼疼痛。报告疼痛的患者被要求填写意大利语版的简短疼痛量表和McGill疼痛问卷，以及101分的疼痛强度视觉模拟量表（VAS）。进行多导睡眠图记录。采用快速傅里叶变换对脑电信号进行分析。计算了4个功率谱波段（04Hz、48Hz、814Hz、1432Hz）。比较疼痛组和非疼痛组非快速眼动（NREM）睡眠时睡眠宏观结构参数和α / δ脑电图功率比。结果42例患者报告慢性疼痛。VAS平均评分为55.2 +/- 23.8（范围10100），疼痛评分指数评分为13.8 +/- 10.2，现时疼痛强度为2.5 +/- 0.8。统计分析表明，伴有疼痛的FSHD患者在非快速眼动睡眠期间α和β节律增加。在非快速眼动睡眠期间的alpha/delta功率比与疼痛测量之间观察到显著的相关性。结论慢性肌肉骨骼疼痛在FSHD患者中很常见，它是睡眠中断的主要机制。
Objective To measure the presence of the alpha-sleep anomaly in facioscapulohumeral muscular dystrophy (FSHD) and to evaluate the association between the sleep electroencephalogram (EEG) pattern and the presence of musculoskeletal pain. Design Cross-sectional study. Setting Sleep laboratory. Subjects Fifty-five consecutive adult FSHD patients, 26 women and 29 men, age 49.6 +/- 15.1 years (range 1876). Interventions Questionnaires and polysomnography. Outcome Measures Patients were asked to indicate if in the 3 months before the sleep study they presented persisting or recurring musculoskeletal pain. Patients who reported pain were asked to fill in the Italian version of the Brief Pain Inventory and the McGill Pain questionnaire, and a 101-point visual analog scale (VAS) for pain intensity. Polysomnographic recordings were performed. EEG was analyzed by means of Fast Fourier Transform. Four power spectra bands ( 04Hz, 48Hz, 814Hz, 1432Hz) were computed. Sleep macrostructure parameters and alpha/delta EEG power ratio during non rapid eye movement (NREM) sleep were compared between patients with and without pain. Results Forty-two patients in our sample reported chronic pain. VAS mean score was 55.2 +/- 23.8 (range 10100), pain rating index score was 13.8 +/- 10.2, and present pain intensity was 2.5 +/- 0.8. The statistical analysis documented an increased occurrence of the alpha and beta rhythms during NREM sleep in FSHD patients with pain. Significant correlations were observed between the alpha/delta power ratio during NREM sleep and pain measures. Conclusions Chronic musculoskeletal pain is frequent in FSHD patients, and it represents a major mechanism of sleep disruption.