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Spektor E, Fietze I, Poluektov MG. Periodic Limb Movements Syndrome in Patients With Cerebral Small Vessel Disease: Protocol for a Prospective Observational Study. Front Neurol 2021; 12:700151. [PMID: 34646228 PMCID: PMC8503532 DOI: 10.3389/fneur.2021.700151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Cerebrovascular diseases are the leading cause of cognitive decline and dementia. Therefore, the investigation of the potential ways to slow down the disease progression is an important research field. Periodic limb movements in sleep (PLMS) are known to be associated with transient changes in heart rate and blood pressure. These changes might influence the course of cerebral small vessel disease (cSVD). Nevertheless, the clinical significance of PLMS, particularly its influence on cardiovascular diseases course, is still controversial and underinvestigated. Methods/design: Patients from 60 to 75 years old diagnosed with cSVD will undergo nocturnal polysomnography. Subjects with apnea/hypopnea index under 5 will be enrolled. Sleep quality and daytime functioning will be assessed at baseline with self-reported questionnaires. Brain MRI and cognitive assessment will be performed at baseline and in the 2-year follow-up. Progression of cSVD markers and cognitive dysfunction will be compared between patients with PLMS index (PLMI) equal to or more than 15 movements per hour of sleep and controls (PLMI <15/h). Discussion: The negative role of PLMS in cSVD progression and related cognitive decline is expected. We suppose that patients with PLMS tend to worsen in cognitive performance more rapidly than age-, gender-, and comorbidity-matched controls. We also expect them to have more rapid white matter hyperintensities and other cSVD marker progression. The limitations of the study protocol are the short follow-up period, the absence of a treatment group, and inability to make a conclusion about causality.
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Affiliation(s)
- Ekaterina Spektor
- Department of Sleep Medicine, Chair of Neurology and Neurosurgery, University Clinical Hospital No. 3, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ingo Fietze
- Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,The Fourth People's hospital of Guangyuan, Guangyuan City, China.,The Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Mikhail G Poluektov
- Department of Sleep Medicine, Chair of Neurology and Neurosurgery, University Clinical Hospital No. 3, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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van der Salm SMA, Erro R, Cordivari C, Edwards MJ, Koelman JHTM, van den Ende T, Bhatia KP, van Rootselaar AF, Brown P, Tijssen MAJ. Propriospinal myoclonus: clinical reappraisal and review of literature. Neurology 2014; 83:1862-70. [PMID: 25305154 DOI: 10.1212/wnl.0000000000000982] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Propriospinal myoclonus (PSM) is a rare disorder with repetitive, usually flexor arrhythmic brief jerks of the trunk, hips, and knees in a fixed pattern. It has a presumed generation in the spinal cord and diagnosis depends on characteristic features at polymyography. Recently, a historical paradigm shift took place as PSM has been reported to be a functional (or psychogenic) movement disorder (FMD) in most patients. This review aims to characterize the clinical features, etiology, electrophysiologic features, and treatment outcomes of PSM. METHODS Re-evaluation of all published PSM cases and systematic scoring of clinical and electrophysiologic characteristics in all published cases since 1991. RESULTS Of the 179 identified patients with PSM (55% male), the mean age at onset was 43 years (range 6-88 years). FMD was diagnosed in 104 (58%) cases. In 12 cases (26% of reported secondary cases, 7% of total cases), a structural spinal cord lesion was found. Clonazepam and botulinum toxin may be effective in reducing jerks. CONCLUSIONS FMD is more frequent than previously assumed. Structural lesions reported to underlie PSM are scarce. Based on our clinical experience and the reviewed literature, we recommend polymyography to assess recruitment variability combined with a Bereitschaftspotential recording in all cases.
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Affiliation(s)
- Sandra M A van der Salm
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Roberto Erro
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Carla Cordivari
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Mark J Edwards
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Johannes H T M Koelman
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Tom van den Ende
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Kailash P Bhatia
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Anne-Fleur van Rootselaar
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Peter Brown
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Marina A J Tijssen
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands.
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