The Clinical Evidence of Correlation between Restless Legs Syndrome and Stroke and Possible Pathogenesis

doi:10.3969/j.issn.1673-5765.2017.10.009

Abstract

Abstract:

In recent years the clinical reports of clinical cases regarding restless legs syndrome (RLS) is associated with stroke emerge endlessly. RLS patients suffering from stroke are increasing, and occurrence of post-stroke RLS become more common. Recently frequent reports of the clinical studies on RLS and stroke correlation have also proved the above mentioned conclusions. Therefore, it’s speculated that the pathogenesis of RLS is associated with a number of risk factors for stroke or overlap existing; severe RLS can increase the prevalence of stroke, especially the risk of ischemic stroke, which may be a risk factor for ischemic stroke. However, the causality between RLS and stroke still requires further discussion.

不宁腿综合征与卒中密切相关，可以互为因果，不宁腿综合征可增加缺血性卒中风险，临床应高度重视。

Key words: Restless legs syndrome; Stroke; Correlation; Pathogenesis

摘要：

近年来临床报道的不宁腿综合征（restless legs syndrome，RLS）与卒中相关联的临床病例层出不穷，RLS患者罹患卒中的比例增加，卒中后出现RLS亦较常见。近年来频繁报道的RLS与卒中相关性临床研究，也认证了上述的结论。推测RLS发病机制与卒中的多项危险因素相关或重叠存在，重度的RLS增加了卒中，尤其缺血性卒中的风险，并可能成为缺血性卒中的危险因素，但RLS与卒中之间的因果关系尚需要进一步探讨。

关键词: 不宁腿综合征; 卒中; 相关性; 发病机制

郑姣琳，陈红媛，王化冰. 不宁腿综合征与卒中相关性的临床证据和可能机制[J]. 中国卒中杂志, 2017, 12(10): 930-936.

References

[1] ALLEN R P，PICCHIETTI D，HENING W A，et al.

Restless legs syndrome：diagnostic criteria，special

considerations，and epidemiology. A report from the

restless legs syndrome diagnosis and epidemiology

workshop at the National Institutes of Health[J].

Sleep Med，2003，4（2）：101-119.

[2] LEE S J，KIM J S，SONG I U，et al. Poststroke

restless legs syndrome and lesion location：

anatomical considerations[J]. Mov Disord，2009，24

（1）：77-84.

[3] SCHLESINGER I，ERIKH I，NASSAR M，et al.

Restless legs syndrome in stroke patients[J]. Sleep

Med，2016，16（8）：1006-1010.

[4] MARQUEZ-ROMERO J M，MORALESRAMÍREZ

M，ARAUZ A. Non-breathing-related

sleep disorders following stroke[J]. Neurologia，2014，

29（9）：511-516.

[5] NOGUÉS M，CAMMAROTA A，LEIHUARDA R，

et al. Periodic limb movements in syringomyelia and

syringobulbia[J]. Mov Disord，2000，15（1）：113-

119.

[6] KIM J S，LEE S B，PARK S Y，et al. Periodic limb

movement during sleep developed after pontine

lesion[J]. Mov Disord，2003，18（11）：1403-1405.

[7] SCHÖLS L，HAAN J，RIESS O，et al. Sleep

disturbance in spinocerebellar ataxias：is the SCA3

mutation a cause of restless legs syndrome?[J].

Neurology，1998，51（6）：1603-1607.

[8] ONDU W G. Restless Legs Syndrome and Akathisia//

JANKOVIC J，EDUARDO TOLOSA. Parkinsons

Disease and Movement Disorders[M]. 6th Edition，

Wolters Kluwer Health，2015：E1097-E1128.

[9] KANG S Y，SOHN Y H，LEE I K，et al. Unilateral

periodic limb movement in sleep after supratentorial

cerebral infarction[J]. Parkinsonism Relat Disord，

2004，10（7）：429-431.

[10] LEE J S，LEE P H，HUH K. Periodic limb

movements in sleep after a small deep subcortical

infarct[J]. Mov Disord，2005，20（2）：260-261.

[11] SECHI G，AGNETTI V，GALISTU P，et al. Restless

legs syndrome and periodic limb movements after

ischemic stroke in the right lenticulostriate region[J].

Parkinsonism Relat Disord，2008，14（2）：157-160.

[12] 刘水乔，许春伶，赵明霞，等. 脑梗死继发不宁腿综

合征1例并文献复习[J]. 临床和实验医学杂志，2014，

13（2）：109-112.

[13] GUPTA A，SHUKLA G，MOHAMMED A，et al.

Restless legs syndrome，a predictor of subcortical

stroke：a prospective study in 346 stroke patients[J].

Sleep Med，2017，29（5）：61-67.

[14] ELWOOD P，HACK M，PICKERING J，et al.

Sleep disturbance，stroke，and heart disease events：

evidence from the Caerphilly cohort[J]. J Epidemiol

Community Health，2006，60（1）：69-73.

[15] WALTERS A S，MOUSSOUTTAS M，SIDDIQUI F，

et al. Prevelence of stroke in restless legs syndrome：

initial results point to the need for more sophisticated

studies[J]. Open Neurol J，2010，4：73-77.

[16] COSENTINO F I，ARICÒ D，LANUZZA B，et

al. Absence of cardiovascular disease risk factors in

restless legs syndrome[J]. Acta Neurol Scand，2012，

125（5）：319-325.

[17] WALTERS A S，RYE D B. Review of the

relationship of restless legs syndrome and periodic

limb movements in sleep to hypertension，heart

disease，and stroke[J]. Sleep，2009，32（5）：589-

597.

[18] 于建华，肖新兰. 不宁腿综合征脑内铁代谢异常的

MRI测量研究进展[J]. 临床放射学杂志，2014，33

（4）：631-633.

[19] 杨洋，彭华，孙文静，等. 不宁腿综合征铁代谢异常

的研究进展[J]. 中华神经医学杂志，2015，14（11）：

1180-1184.

[20] ULFBERG J，NYSTRÖM B，CARTER N，et al.

Prevalence of restless legs syndrome among men

aged 18 to 64 years：an association with somatic

disease and neuropsychiatric symptoms[J]. Mov

Disord，2001，16（6）：1159-1163.

[21] SCHEPENS B，STAPLEY P，DREW T. Neurons

in the pontomedullary reticular formation signal

posture and movement both as an integrated behavior

and independently[J]. J Neurophysiol，2008，100（4）：

2235-2253.

[22] BOURGIN P，ESCOURROU P，GAULTIER C，et al.

Induction of rapid eye movement sleep by carbachol

infusion into the pontine reticular formation in the

rat[J]. Neuroreport，1995，6（3）：532-536.

[23] BRISCHOUX F，MAINVILLE L，JONES B E.

Muscarinic-2 and orexin-2 receptors on GABAergic

and other neurons in the rat mesopontine tegmentum

and their potential role in sleep-wake state control[J].

J Comp Neurol，2008，510（6）：607-630.

[24] ERDEN E C，ERDEN ?，TÜRKER Y，et al.

Incremental effects of restless legs syndrome on

nocturnal blood pressure in hypertensive patients

and normotensive individuals[J]. Blood Press Monit，

2012，17（6）：231-234.

[25] PENNESTRI M H，MONTPLAISIR J，COLOMBO

R，et al. Nocturnal blood pressure changes in

patients with restless legs syndrome[J]. Neurology，

2007，68（15）：1213-1218.

[26] BYUN J I，JUNG K Y，LEE G T，et al. Spontaneous

low frequency cerebral hemodynamics oscillations in

restless legs syndrome with periodic limb movements

during sleep：a near-infrared spectroscopy study[J].

J Clin Neurol，2016，12（1）：107-114.

[27] EGAN B M. Insulin resistance and the sympathetic

nervous system[J]. Current Hypertens Rep，2003，5

（3）：247-254.

[28] SPIEGEL K，TASALI E，LEPROULT R，et

al. Effects of poor and short sleep on glucose

metabolism and obesity risk[J]. Nat Rev Endocrinol，

2009，5（5）：253-261.

[29] HERRMANN M，BARTELS C，SCHUMACHER

M，et al. Poststroke depression. Is there a

pathoanatomic correlate for depression in the

postacute stage of stroke?[J]. Stroke，1995，26（5）：

850-856.

[30] BECKER P M，SHARON D. Mood disorders in

restless legs syndrome （Willis-Ekbom disease）[J].

J Clin Psychiatry，2014，75（7）：e679-e694.

[31] BAUGHMAN K R，BOURGUET C C，OBER S

K. Gender difference in the association between

antidepressant use and restless legs syndrome[J].

Nov Disord，2009，24（7）：1054-1059.

[32] SAKKAS G K，HADJIGEORGIOU G M，

KARATZAFERI C，et al. Intradialytic aerobic

exercise training ameliorates symptoms of restless

legs syndrome and improves functional capacity in

patients on hemodialysis：a pilot study[J]. ASAIO J，

2008，54（2）：185-190.

[33] AUKERMAN M M，AUKERMAN D，BAYARD

M，et al. Exercise and restless legs syndrome：a

randomized controlled trial[J]. J Am Board Fam Med，

2006，19（5）：487-493.

[34] SCHLESIGNER I，ERIKH I，AVIZOHAR O，et

al. Cardiovascular risk factor sin restless legs

syndrome[J]. Mov Disord，2009，24（11）：1587-

1592.

[35] VON RUESTEN A，WEIKERT C，FIETZE I，et al.

Association of sleep duration with chronic disease in

the European Prospective Investigation into Cancer

and Nutrition（EPIC）-Postdam study[J]. PLoS One，

2012，7（1）：e30972.

[36] SHANKAR A，SYAMALA S，KALIDINDI

S. Insufficient rest or sleep and its relation to

cardiovascular disease，diabetes and obesity in a

national，multiethnic sample[J]. PLoS One，2010，5

（11）：e14189.

[37] 赵忠新，张照环. 分别从临床与细胞水平看睡眠障碍

与脑血管病之间的联系[J]. 中国卒中杂志，2015，10

（1）：15-19.

[38] PROVINI F，ANTELMI E，VIGNATELLI L，et

al. Increased prevalence of nocturnal smoking in

restless legs syndrome （RLS）[J]. Sleep Med，2010，

11（2）：218-220.

[39] BERGER K，LUEDEMANN J，TRENKWALDER

C，et al. Sex and the risk of restless legs syndrome

in the general population[J]. Arch Intern Med，2004，

164（2）：196-202.

[40] MEDEIROS C A，DE BRUIN P F，PAIVA T R，et

al. Clinical outcome after acute ischemic stroke：the

influence of restless legs syndrome[J]. Eur J Neurol，

2011，18（1）：144-149.

[41] FERRE A，RIBÓ M，RODRÍGUEZ-LUNA D，et al.

Strokes and their relationship with sleep and sleep

disorders[J]. Neurologia，2013，28(2):103-118.