Silent Cerebral Small Vessel Disease in Restless Legs Syndrome.

Study Objectives: Growing literature suggests that patients with restless legs syndrome (RLS) may be at increased risk for hypertension, heart disease, and stroke. Cerebral small vessel disease (SVD) is a known risk factor for clinical stroke. This study evaluated silent cerebral SVD by MRI in patients with RLS, in the absence of a history of previous clinical stroke or known stroke risk factors and taking into account disease duration.

Direct comparison of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome and restless legs syndrome.

Objective: Changes to transcranial magnetic stimulation (TMS) have been reported in obstructive sleep apnea syndrome (OSAS) and restless legs syndrome (RLS), although no direct comparison study is available. The aim of this new investigation is to assess and compare cortical excitability of OSAS and RLS patients using the same methodology and under the same experimental conditions.

Methods: Fourteen patients with OSAS and 12 with RLS were compared to 14 age-matched controls.

Increased electroencephalographic high frequencies during the sleep onset period in patients with restless legs syndrome.

Study Objectives: To analyze the electroencephalographic (EEG) spectral content in untreated patients with restless legs syndrome (RLS) during the sleep onset period (SOP) and during the quiet wakefulness preceding sleep, in order to test the hypothesis that a state of hyperarousal might be present during the SOP with RLS.

Setting: Sleep Research Centre.

Patients: Twenty-seven untreated consecutive patients with RLS (mean age = 53.

A case of REM sleep behavior disorder, narcolepsy-cataplexy, parkinsonism, and rheumatoid arthritis.

A patient is reported in whom signs and symptoms of REM sleep behavior disorder (RBD) and narcolepsy have been associated for almost two decades with a late development of parkinsonism and rheumatoid arthritis. A 78-year-old male patient in whom RBD was first diagnosed was followed-up by clinical examination, video-polysomnography, multiple sleep latency test, cerebral magnetic resonance imaging, and dopamine transporter imaging by single-photon emission computerized tomography. The patient was found to present for almost two decades, in addition to RBD, also narcolepsy.

The timing between REM sleep behavior disorder and Parkinson's disease.

Purpose: In Parkinson's disease (PD) patients, REM sleep behavior disorder (RBD) might precede PD or develop with or after the onset of PD. No previous study has explored differences between these two groups. The aim of this study was therefore to compare clinical features and REM sleep chin electromyographic patterns between patients in whom RBD heralded PD and those in whom RBD occurrence coincided with or followed the clinical manifestations of PD.

Night-to-night variability of automatic quantitative parameters of the chin EMG amplitude (Atonia Index) in REM sleep behavior disorder.

Study Objectives: To analyze the night-to-night variability of REM sleep electromyographic (EMG) features of REM sleep behavior disorder (RBD) by using the automatic quantitative method known as atonia index (AI), and to evaluate the improvement in sensitivity and specificity of AI for the diagnosis of RBD when a second recording night is available.

Setting: Sleep research center.

Interventions: N/A.

Cortical sources of resting state EEG rhythms are sensitive to the progression of early stage Alzheimer's disease.

Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with Alzheimer's disease (AD). Here we tested the hypothesis that these sources are also sensitive to the progression of early stage AD over the course of one year. The resting state eyes-closed EEG data were recorded in 88 mild AD patients at baseline (Mini Mental State Evaluation, MMSE I = 21.

Polysomnographic study of nocturnal sleep in idiopathic hypersomnia without long sleep time.

We investigated nocturnal sleep abnormalities in 19 patients with idiopathic hypersomnia without long sleep time (IH) in comparison with two age- and sex- matched control groups of 13 normal subjects (C) and of 17 patients with narcolepsy with cataplexy (NC), the latter considered as the extreme of excessive daytime sleepiness (EDS). Sleep macro- and micro- (i.e.

A preliminary quantitative analysis of REM sleep chin EMG in Parkinson's disease with or without REM sleep behavior disorder.

Objectives: To compare REM sleep chin EMG quantitative features between Parkinson's disease (PD) patients with or without REM sleep behavior disorder (RBD).

Subjects And Methods: Twenty-seven consecutive PD patients (mean age 67.9 years) and 19 normal controls (mean age 67.

Leg movements during wakefulness in restless legs syndrome: time structure and relationships with periodic leg movements during sleep.

Background And Objective: Approximately one third of patients with restless legs syndrome (RLS) also show periodic leg movements (PLM) during relaxed wake fulness (PLMW). In contrast with the large amount of data published on periodic leg movements during sleep (PLMS), PLMW have received less attention from the scientific community. The objective of this study was to evaluate the correlations/differences of time-structure and response to a dopamine-agonist between PLMW and PLMS in patients with RLS.

The CC genotype of transforming growth factor-β1 increases the risk of late-onset Alzheimer's disease and is associated with AD-related depression.

Transforming growth factor-β1 (TGF-β1) is a neurotrophic factor that exerts neuroprotective effects against β-amyloid-induced neurodegeneration. Recently, a specific impairment of the TGF-β1 signaling pathway has been demonstrated in Alzheimer's disease (AD) brain. TGF-β1 is also involved in the pathogenesis of depressive disorders, which may occur in 30-40% of AD patients.

Restless legs syndrome is frequent in narcolepsy with cataplexy patients.

Study Objectives: To investigate the occurrence of restless legs syndrome (RLS) in narcolepsy with cataplexy (NC).

Design: A case-control study assessing the frequency of comorbidity of RLS and NC in three European sleep disorder centers.

Patients: Three sleep research centers recruited 184 NC patients and 235 age-matched controls.

Behavioural and neurophysiologic features of state dissociation: A brief review of the literature and three descriptive case studies.

Wakefulness, rapid eye movement (REM) and non-REM sleep are not always mutually exclusive conditions, as commonly assumed. In some cases, the declaration of any state may be incomplete and states can fluctuate rapidly, resulting in peculiar behavioural syndromes such as narcolepsy, REM sleep behaviour disorder and status dissociatus. We briefly introduce this topic and discuss three suggestive clinical cases.

Subclinical abnormal EMG activation of the gastrocnemii during gait analysis in restless legs syndrome: a preliminary report in 13 patients.

Objective: The purpose of this study was to detect the eventual presence of a minor voluntary motor involvement in restless legs syndrome (RLS), not detectable clinically, which might be observed by means of a sophisticated instrumental analysis of movement, such as gait analysis.

Subjects And Methods: Gait analysis was performed and surface EMG activity was recorded in 13 RLS patients and 8 normal controls from 8 muscles: tibialis anterior, gastrocnemius lateralis, gastrocnemius medialis, and soleus in both legs.

Results: Ten out of the 13 RLS patients and none of the normal control group showed a mild abnormality of the EMG activation of the gastrocnemius muscles during gait which, however, had no detectable effects on its kinematics.

The APOE epsilon4 allele increases the risk of impaired spatial working memory in obstructive sleep apnea.

Background: Contradictory data have been published on the influence of Apolipoprotein E (APOE) epsilon4 allele on obstructive sleep apnea (OSA). The aims of this study were to confirm the presence of specific neuropsychological changes in OSA patients carrying the APOE epsilon4 allele and to clarify if these changes are due to the sole presence of this allele or to its interactions with OSA pathology.

Methods: The APOE genotype was examined in 123 patients with OSA and in 121 controls, together with a series of neuropsychological tests.

Age-related changes in periodic leg movements during sleep in patients with restless legs syndrome.

Objective: The aim of this study was to evaluate and statistically describe the age-related changes in leg movements (LMs) during sleep in a large group of subjects with restless legs syndrome (RLS).

Subjects And Methods: One hundred eight untreated patients affected by idiopathic RLS were included in this study (mean age 52.0years, min 7.

Agrypnia excitata in a patient with progeroid short stature and pigmented Nevi (Mulvihill-Smith syndrome).

We report the video-polysomnographic sleep characteristics of a 25-year-old woman with the Mulvihill-Smith syndrome, a rare clinical condition characterized by progeria-like aspect, peculiar multiple pigmented nevi, low stature, and cognitive impairment. Among the various exams, two overnight video-polysomnographic recordings were carried out; moreover, cerebral MRI and molecular analysis of the prion protein gene (PRNP) were also performed. The video-polysomnographic recordings showed the absence of clear sleep episodes but the presence of periods during which the patient had poor contact with the environment, stereotyped afinalistic movements of the upper limbs and hands, irregular or periodic breathing (with central apnea episodes), heart rate arrhythmia, and rapid eye movements.

The neurophysiology of the alternating leg muscle activation (ALMA) during sleep: study of one patient before and after treatment with pramipexole.

Background And Purposes: To report the neurophysiological features of a patient with alternating leg muscle activation (ALMA) during sleep, a quickly alternating pattern of anterior tibialis activation which might represent transient facilitation of a spinal central pattern generator for locomotion, perhaps due to the serotonergic effects of antidepressant medication.

Patient And Methods: A 33-year-old male patient with ALMA. The patient underwent a complete and detailed study of his neurophysiological parameters during sleep, before and after treatment with pramipexole.

Different EEG frequency band synchronization during nocturnal frontal lobe seizures.

Objective: In this article we describe the course of synchronization between different EEG channels during nocturnal seizures in one patient with nocturnal frontal lobe epilepsy (NFLE).

Methods: The functional interactions between the different EEG channels during the nocturnal seizures were analyzed by means of the so-called synchronization likelihood (SL). SL is a measure of the dynamical interdependencies between a time series (EEG channel) and one or more other time series.