Connecting clinical aspects to corticomotor excitability in restless legs syndrome: a TMS study.
Connecting clinical aspects to corticomotor excitability in restless legs syndrome: a TMS study.
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将临床方面与不宁腿综合征的皮质运动兴奋性联系起来：一项 TMS 研究。
DOI：
10.1016/j.sleep.2018.05.002
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发表时间：
2018
期刊：
影响因子：
4.8
通讯作者：
Allen,RichardP
中科院分区：
文献类型：
--
作者：
Salas,RachelMarieE;Kalloo,Aadi;Earley,ChristopherJ;Celnik,Pablo;Cruz,TianaE;Foster,Keyana;Cantarero,Gabriela;Allen,RichardP
我们使用经颅磁刺激(TMS)评估了具有中到重度不宁腿综合征(RLS)症状的参与者初级运动皮质(M1)的皮质运动兴奋性与疾病的临床和睡眠方面的关系。35名受试者(20岁；平均年龄：59.23±61.66岁；范围：42-78岁)受原发RLS(停药)影响，31名年龄匹配的对照组(19岁女性；平均年龄：57.90±111.50岁；范围：43-79岁)在两晚多导睡眠图(PSG)后接受了TMS。收集双脉冲TMS测量结果[短间隔皮质内抑制(SICI)、长间隔皮质内抑制(LICI)和皮质内促进(ICF)]，并分析其与RLS和PSG临床特征的关系。我们发现M1手的皮质运动兴奋性降低，而M1腿的皮质运动兴奋性增加，这在RLS越严重的患者中越明显。有多巴胺激动剂诱导症状增强病史的RLS患者与M1Leg的RLS患者相比，LICI(抑制程度降低)降低。所有TMS测量(M1handor M1Leg)均与PSG参数无关。这项研究表明，M1腿的兴奋性过度，这似乎与RLS疾病的严重程度和M1手的兴奋性降低有关。这些结果为了解RLS的复杂神经生物学提供了新的见解，特别是在疾病的更晚期。
We assessed corticomotor excitability in the primary motor cortex (M1) of participants with moderate-to-severe restless legs syndrome (RLS) symptoms using transcranial magnetic stimulation (TMS) in relation to the clinical and sleep aspects of the disease. Thirty-five participants (20 F; mean age: 59.23 ± 1.66 years; range: 42–78 years) affected by primary RLS (off medications) and 31 age-matched controls (19 F; mean age: 57.90 ± 1.50 years; range: 43–79 years) underwent TMS following two nights of polysomnography (PSG). Paired-pulse TMS measures [short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI), and intracortical facilitation (ICF)] of the dominant M1handand M1legmuscles were collected and analyzed in relation to clinical features of RLS and PSG. We found decreased corticomotor excitability in M1hand, whereas it was increased in M1leg, which was greater in patients with more severe RLS. Participants with RLS with a history of dopamine-agonist–induced symptom augmentation showed decreased LICI (reduced inhibition) compared to nonaugmented participants with RLS for M1leg. None of the TMS measures (M1handor M1leg) correlated with the PSG parameters. This study shows hyperexcitability in M1leg, and this appears related to RLS disease severity and decreased excitability in M1hand. The results provide new insight into the complex neurobiology of RLS, particularly in more advanced stages of the disease.