The Study Of Dynamic Cerebral Autoregulation In Patients With Restless Legs Syndrome

Objective:To explore the dynamic cerebral autoregulation in patients with restless legs syndrome,and to find the potential therapeutic target for improving symptoms of patients with restless legs syndrome.In order to identify early and intervene the influencing factors in time,so as to improve the quality of life of patients.Methods:In this study,we selected 48 patients diagnosed as RLS in the Department of Neurology,First Hospital of Jilin University from June 2017 to December 2018 according to the RLS diagnostic criteria(revised version in 2014)established by the International RLS Study Group.According to the IRLS scale,the patients were divided into mild RLS group,moderate RLS group,severe RLS group and extremely severe RLS group.And we chose 12 healthy volunteers matched in age,sex and other aspects,who cooperated with and informed consent during the whole process of the study as the control group.We used video polysomnography to analyze the sleep structure,leg movement index and awakening index of patients.TCD and continuous fingertip blood pressure monitor were used to synchronously record bilateral middle cerebral artery blood flow velocity(CBFV)and arterial blood pressure(ABP)for 10 minutes.We used transfer function analysis(TFA)to derive the parameters of dynamic cerebral blood flow automatic regulation: gain,phase difference(PD),correlation function and then to evaluate the changes of dynamic cerebral autoregulation in patients with restless legs syndrome.Results:The sleep structure characteristics of different groups of RLS patients and control group showed that there were significant differences in total sleep time,N1%,N3%,REM%,sleep efficiency,awakening index and periodic limb movement index.Compared with the control group,the left and right phase differences in moderate RLS group,severe RLS group and extremely severe RLS group were significantly decreased(P<0.05),suggesting that the function of dCA was impaired.The left and right phase differences after one month of treatment were significantly different from those before treatment.The relationship between clinical factors and dCA parameters was analyzed by univariate regression model.It was found that total sleep time,sleep efficiency,awakening index and periodic limb movement index were correlated with the decrease of phase difference.Conclusion:The sleep structure of RLS patients was disordered.They were characterized by reduced total sleep time,low sleep efficiency,increased legs movement index and awakening index.The dynamic cerebral autoregulation was impaired in moderate,severe and extremely severe RLS patients.The dCA function of RLS patients was improved after treatment.Total sleep time,sleep efficiency,awakening index and periodic limb movement index were correlated with impaired cerebral blood flow autoregulation in patients with RLS.