Periodic Limb Movements During Sleep are More Severe in Narcolepsy with Cataplexy than in Narcolepsy without Cataplexy


Authors: J. Krpešová;  D. Kemlink;  V. Ibarburu;  S. Dostálová;  J. Bušková;  J. Piško;  P. Kovalská;  I. Příhodová;  K. Šonka
Authors‘ workplace: Neurologická klinika a Centrum klinických neurověd 1. LF UK a VFN v Praze
Published in: Cesk Slov Neurol N 2017; 80/113(1): 70-74
Category: Original Paper

Overview

Introduction:
Periodic limb movements in sleep (PLMS) are repetitive stereotyped movements of extremities, particularly of the legs. Some studies identified narcolepsy to be associated with higher PLMS occurrence.

Methods:
A retrospective study including 78 patients with narcolepsy with cataplexy (NC) and 29 patients with narcolepsy without cataplexy (NwoC) aged 19 to 86 years, 50 women and 57 men. All subjects underwent a clinical examination including video-polysomnography 8 hours at night time and the multiple sleep latency test (MSLT).

Results:
PLMS characterized by the periodic leg movements index (PLMI – number of periodic leg movements per 1 hour) ≥ 15 were found in 40% of the total of 107 patients – 43% of NC and 32% of NwoC. PLMS was associated with higher age and with lower sleep efficacy. The mean PLMI of NC and NwoC was different 24.3 ± 30.2 and 12.6 ± 20.8, resp. Similar values were identified when subjects not using antidepressants during the study were evaluated in these same subgroups. PLMI values (31.2 ± 33.3) were higher in patients using antidepressants than in patients never taking antidepressants (15.4 ± 23.7), irrespective of whether antidepressants were used before the study only or before and during the study. However, patients with the history of antidepressants use were older.

Conclusion:
PLMS are frequent comorbidity in NC and it is more frequent in NC than in NwoC.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Key words:
narcolepsy with cataplexy – narcolepsy without cataplexy – periodic limb movements in sleep – antidepressants – comorbidity


Chinese summary - 摘要

在睡眠中周期性肢体动作严重与猝倒发作性睡病比嗜睡症

无猝倒

摘要

简介:

在睡眠中周期性肢体运动(PLMS)特别重复动作睡眠时下肢。一些报告描述PLMS的发病率较高

发作性睡病。

方法:

78例患者从患嗜睡症与猝倒症(NK)和29的回顾性研究患者发作性睡病猝倒无(NbezK)(年龄从19年〜86岁,50名妇女和57男性)。所有患者进行临床检查,视频多导睡眠图晚上8点

在晚上的时间,多睡眠潜伏期试验。

结果:

每小时PLMS的特点是周期性运动(PLMI)≥15表明总集107例,40%的组中的NK的43%,并在基

NbezK 32%。发生PLMS与年龄和较低的时间有关效率。直径在PLMI NK(24.3±SD = 30.2)是从平均PLMI不同NbezK(12.6±20.8)和非常相似的结果在上述时所获得组进行了评价只有谁是在考试的时候治疗的患者抗抑郁药。 PLMI患者接受抗抑郁药,无论以前或在时间记录(31.2±33.3)高于谁从未接受过抗抑郁药的患者高(15.4±23.7),但患者的抗抑郁药治疗的历史是老年人。

结论:

PLMS频繁合并症NK,往往比NbezK。

关键词:

发作性睡病与猝倒 - 发作性睡病猝倒没有 - 在周期性肢体运动睡眠 - 抗抑郁药 - 合并症


Sources

1. Peyron C, Faraco J, Rogers W, et al. A mutation in a case of early onset narcolepsy and a generalized absence of hypocretin peptides in human narcoleptic brains. Nat Med 2000;6(9):991– 7.

2. Than­nickal TC, Moore RY, Nienhuis R, et al. Reduced number of hypocretin neurons in human narcolepsy. Neuron 2000;27(3):469– 74.

3. American Academy of Sleep Medicine. International clas­sification of sleep disorders. 2nd ed. Westchester, Il­linois: American Academy of Sleep Medicine 2005.

4. Partinen M, Kornum BR, Plazzi G, et al. Narcolepsy as an autoim­mune disease: the role of H1N1 infection and vaccination. Lancet Neurol 2014;13(6):600– 13. doi: 10.1016/ S1474-4422(14)70075-4.

5. Liblau RS, Vas­sal­li A, Seifinejad A, et al. Hypocretin (orexin) bio­logy and the pathophysiology of narcolepsy with cataplexy. Lancet Neurol 2015;14(3):318– 28. doi: 10.1016/ S1474-4422(14)70218-2.

6. Tafti M, Hor H, Dauvil­liers Y, et al. DQB1 locus alone explains most of the risk and protection in narcolepsy with cataplexy in Europe. Sleep 2014;37(1):19– 25. doi: 10.5665/ sleep.3300.

7. Iber C, Ancoli-Israel S, Ches­son A. The AASM Manual for the scor­ing of sleep and as­sociated events: rules, terminology and technical specifications. 1st ed. Westchester, Il­linois: American Academy of Sleep Medicine 2007.

8. Kemlink D, Pretl M, Sonka K, et al. A comparison of polysomnographic and actigraphic evaluation of periodic limb movements in sleep. Neurol Res 2008;30(3):234– 8.

9. Kemlink D, Vávrová J. Syndrom neklidných nohou. Cesk Slov Neurol N 2011;74/ 107(2):141– 9.

10. Buskova J, Vorlova T, Pisko J, et al. Severe sleep-related movement disorder induced by sertraline. Sleep Med 2012;13(6):769– 70. doi: 10.1016/ j.sleep.2012.01.006.

11. Yang C, White DP, Winkelman JW. Antidepres­sants and periodic leg movements of sleep. Biol Psychiatry 2005;58(6):510– 4.

12. Zhang B, Hao Y, Jia F, et al. Sertraline and periodic limb movements dur­ing sleep: an 8-week open-label study in depres­sed patients with insomnia. Sleep Med 2013;14(12):1405– 12. doi: 10.1016/ j.sleep.2013.07.019.

13. Wittig R, Zorick F, Piccione P, et al. Narcolepsy and disturbed nocturnal sleep. Clin Electroencephalogr 1983;14(3):130– 4.

14. Dauvil­liers Y, Pen­nestri MH, Petit D, et al. Periodic leg movements dur­ing sleep and wakefulness in narcolepsy. J Sleep Res 2007;16(3):333– 9.

15. Mayer G, Kesper K, Peter H, et al. Comorbidity in narcoleptic patients. Dtsch Med Wochenschr 2002;127(38):1942– 6.

16. Fer­ri R, Zucconi M, Manconi M, et al. Dif­ferent periodicity and time structure of leg movements dur­ing sleep in narcolepsy/ cataplexy and restless legs syndrome. Sleep 2006;29(12):1587–94.

17. Pizza F, Tartarotti S, Poryazova R, et al. Sleep-disordered breath­ing and periodic limb movements in narcolepsy with cataplexy: a systematic analysis of 35 consecutive patients. Eur Neurol 2013;70(1– 2):22– 6. doi: 10.1159/ 000348719.

18. Nevsimalova S, Pisko J, Buskova J, et al. Narcolepsy: clinical dif­ferences and as­sociation with other sleep disorders in dif­ferent age groups. J Neurol 2013;260(3):767– 75. doi: 10.1007/ s00415-012-6702-4.

19. Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 2005;28(1):113– 21.

20. Johns MW. A new method for measur­ing daytime sleepines­s: the Epworth sleepiness scale. Sleep 1991;14(6):540– 5.

21. Vaz Fragoso CA, Van Ness PH, Araujo KL, et al. Age-related dif­ferences in sleep-wake symp­toms of adults undergo­ing polysomnography. J Am Geriatr Soc 2015;63(9):1845– 51. doi: 10.1111/ jgs.13632.

22. Scofield H, Roth T, Drake C. Periodic limb movements dur­ing sleep: population prevalence, clinical cor­relates, and racial dif­ferences. Sleep 2008;31(9):1221– 7.

23. Pizza F, Vandi S, Iloti M, et al. Nocturnal sleep dynamics identify narcolepsy Type 1. Sleep 2015;38(8):1277– 84. doi: 10.5665/ sleep.4908.

24. Baham­mam A. Periodic leg movements in narcolepsy patients: impact on sleep architecture. Acta Neurol Scand 2007;115(5):351– 5.

25. Sasai-Sakuma T, Kinoshita A, Inoue Y. Polysomnographic as­ses­sment of sleep comorbidities in drug-naive narcolepsy-spectrum disorders –  a Japanese cros­s--sectional study. PloS One 2015;10(8):e0136988. doi: 10.1371/ journal.pone.0136988.

26. Montplaisir J, Michaud M, Denesle R, et al. Periodic leg movements are not more prevalent in insomnia or hypersomnia but are specifical­ly as­sociated with sleep disorders involv­ing a dopaminergic impairment. Sleep Med 2000;1(2):163– 7.

27. Dauvil­liers Y, Pen­nestri MH, Whittom S, et al. Autonomic response to periodic leg movements dur­ing sleep in narcolepsy-cataplexy. Sleep 2011;34(2):219– 23.

28. Silber MH, Rye DB. Solv­ing the mysteries of narcolepsy: the hypocretin story. Neurology 2001;56(12):1616– 8.

29. Korotkova TM, Sergeeva OA, Eriks­son KS, et al. Excitation of ventral tegmental area dopaminergic and non-dopaminergic neurons by orexins/ hypocretins. J Neurosci 2003;23(1):7– 11.

30. Okura M, Fujiki N, Ripley B, et al. Narcoleptic canines display periodic leg movements dur­ing sleep. Psychiatry Clin Neurosci 2001;55(3):243– 4.

31. Boivin DB, Lor­rain D, Montplaisir J. Ef­fects of bromocriptine on periodic limb movements in human narcolepsy. Neurology 1993;43(10):2134– 6.

32. Than­nickal TC, Nienhuis R, Siegel JM. Localized loss of hypocretin (orexin) cel­ls in narcolepsy without cataplexy. Sleep 2009;32(8):993– 8.

33. Buskova J, Kemlink D, Ibarburu V, et al. Antidepres­sants substantial­ly af­fect basic REM sleep characteristics in narcolepsy-cataplexy patients. Neuro Endocrinol Lett 2015;36(5):430– 3.

34. Šonka K, Nevšímalová S. Klinický standard pro dia­gnostiku a léčbu narkolepsie. In: Suchý M, Bednařík J, eds. Klinické doporučené postupy v neurologii I. Olomouc: Univerzita Palackého v Olomouci 2012: 77– 107.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 1

2017 Issue 1

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account