title: Short-interval leg movements during sleep entail greater cardiac activation than periodic leg movements during sleep in restless legs syndrome patients.
abstract: Periodic leg movements during sleep (PLMS) are sequences of ≥4 motor events with intermovement intervals (IMI) of 10-90 s. PLMS are a supportive diagnostic criterion for restless legs syndrome (RLS) and entail cardiac activation, particularly when associated with arousal. RLS patients also over-express short-interval leg movements during sleep (SILMS), which have IMI <10 s and are organized mainly in sequences of two movements (doublets). We tested whether the cardiac activation associated with SILMS doublets differs from that associated with PLMS in a sample of 25 RLS patients. We analysed time-series of R-R intervals synchronized to the onset of SILMS doublets or PLMS that entailed an arousal during non-rapid eye movement (NREM) sleep. We assessed cardiac activation based on the R-R interval decrease with respect to baseline during NREM sleep without leg movements. We found that the duration of the R-R interval decrease with SILMS doublets was significantly longer than that with PLMS, whereas the maximal decrease in R-R interval was similar. Scoring SILMS in RLS patients may therefore be relevant from a cardiac autonomic perspective.
authors.affiliation: Department of Neurology, IRCCS Oasi, Troina, Italy.
authors.forename: Raffaele
authors.identifier: 0000-0001-6937-3065
authors.initials: R
authors.lastname: Ferri
authors.affiliation: Department of Neurology, IRCCS Oasi, Troina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rundo
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Silvani
authors.affiliation: Department of Neurology, San Raffaele Vita-Salute University, Milan, Italy.
authors.forename: Marco
authors.identifier: 0000-0002-4034-476X
authors.initials: M
authors.lastname: Zucconi
authors.affiliation: Department of Neurology, IRCCS Oasi, Troina, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Aricò
authors.affiliation: Department of Social and Developmental Psychology, Sapienza University, Rome, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.affiliation: Department of Neurology, IRCCS Oasi, Troina, Italy.
authors.forename: Bartolo
authors.initials: B
authors.lastname: Lanuzza
authors.affiliation: Department of Neurology, San Raffaele Vita-Salute University, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.affiliation: Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano and Neurology Department Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Mauro
authors.initials: M
authors.lastname: Manconi
mesh_terms: D000328:Adult; D000368:Aged; D001143:Arousal / Q000502:physiology; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D007866:Leg / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D012148:Restless Legs Syndrome / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D013997:Time Factors
keywords: Willis-Ekbom disease; autonomic control; heart rate