title: Pain and the alpha-sleep anomaly: a mechanism of sleep disruption in facioscapulohumeral muscular dystrophy.
abstract: 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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Sleep laboratory.
  
  
  METHODS
  Fifty-five consecutive adult FSHD patients, 26 women and 29 men, age 49.6 ± 15.1 years (range 18-76).
  
  
  METHODS
  Questionnaires and polysomnography.
  
  
  METHODS
  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 (δ 0-4 Hz, θ 4-8 Hz, α 8-14 Hz, β 14-32 Hz) 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 10-100), 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.
authors: Institute of Neurology, Catholic University, Rome, Italy. dellamarca@rm.unicatt.it
authors: Giacomo
authors: G
authors: Della Marca
authors: Roberto
authors: R
authors: Frusciante
authors: Catello
authors: C
authors: Vollono
authors: Elisabetta
authors: E
authors: Iannaccone
authors: Serena
authors: S
authors: Dittoni
authors: Anna
authors: A
authors: Losurdo
authors: Elisa
authors: E
authors: Testani
authors: Valentina
authors: V
authors: Gnoni
authors: Salvatore
authors: S
authors: Colicchio
authors: Chiara
authors: C
authors: Di Blasi
authors: Carmen
authors: C
authors: Erra
authors: Salvatore
authors: S
authors: Mazza
authors: Enzo
authors: E
authors: Ricci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000513:Alpha Rhythm / Q000502:physiology*; D001611:Beta Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000150:complications* / Q000503:physiopathology; D010146:Pain / Q000150:complications*; D010147:Pain Measurement; D017286:Polysomnography; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D055815:Young Adult