Periodic leg movements during sleep and cerebral hemodynamic changes detected by NIRS

Pizza, Fabio; Biallas, Martin; Wolf, Martin; Valko, Philipp O.

doi:10.1016/j.clinph.2009.05.009

Cited by 18 publications

(19 citation statements)

References 12 publications

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“…The increments in HbO 2 and BV induced by PLMA may be due to increasing autonomic neural activation which is in line with previous studies demonstrating blood pressure and HR increase during PLMA (Ferrillo et al, 2004; Ferri et al, 2007; Siddiqui et al, 2007; Ferri and Zucconi, 2008; Pizza et al, 2009; Pennestri et al, 2013). Different from the invariable decrease in HHb in that study (Pizza et al, 2009), we find more heterogeneous increases or decreases of HHb during PLMA. This discrepancy is probably due to differences between the patients in these two studies.…”

Section: Discussionsupporting

confidence: 89%

“…Only one other study published data on the cerebral hemodynamic changes induced by PLMS and found an increase in HbO 2 and small decrease in HHb during PLMA events (Pizza et al, 2009). The increments in HbO 2 and BV induced by PLMA may be due to increasing autonomic neural activation which is in line with previous studies demonstrating blood pressure and HR increase during PLMA (Ferrillo et al, 2004; Ferri et al, 2007; Siddiqui et al, 2007; Ferri and Zucconi, 2008; Pizza et al, 2009; Pennestri et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…All these studies in patients with OSA reported a cerebral hemodynamic pattern induced by AH events, i.e., HHb increases while HbO 2 decreases during AH. There is only a single study describing cerebral hemodynamics in the prefrontal cortex in PLMS in a small number of heterogeneous patients (Pizza et al, 2009). But the various cardiovascular comorbidities in these patients make it difficult to interpret the cerebral hemodynamic changes because their cardiac function or blood pressure is abnormal and might influence cerebral hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

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The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study

et al. 2016

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Obstructive sleep apnea syndrome (OSA) and restless legs syndrome (RLS) with periodic limb movement during sleep (PLMS) are two sleep disorders characterized by repetitive respiratory or movement events associated with cortical arousals. We compared the cerebral hemodynamic changes linked to periodic apneas/hypopneas with arousals (AHA) in four OSA-patients with periodic limb movements (PLMA) with arousals in four patients with RLS-PLMS using near-infrared spectroscopy (NIRS). AHA induced homogenous pattern of periodic fluctuations in oxygenated (HbO2) and deoxygenated (HHb) hemoglobin, i.e., the decrease of HbO2 was accompanied by an increase of HHb during the respiratory event and resolved to reverse pattern when cortical arousal started. Blood volume (BV) showed the same pattern as HHb but with relative smaller amplitude in most of the AHA events.These changing patterns were significant as Wilcoxon signed-rank tests gave p < 0.001 when comparing the area under the curve of these hemodynamic parameters to zero. By contrast, in PLMA limb movements induced periodic increments in HbO2 and BV (Wilcoxon signed-rank tests, p < 0.001), but HHb changed more heterogeneously even during the events coming from the same patient. Heart rate (HR) also showed different patterns between AHA and PLMA. It significantly decreased during the respiratory event (Wilcoxon signed-rank test, p < 0.001) and then increased after the occurrence of cortical arousal (Wilcoxon signed-rank test, p < 0.001); while in PLMA HR first increased preceding the occurrence of cortical arousal (Wilcoxon signed-rank test, p < 0.001) and then decreased. The results of this preliminary study show that both AHA and PLMA induce changes in cerebral hemodynamics. The occurrence of cortical arousal is accompanied by increased HR in both events, but by different BV changes (i.e., decreased/increased BV in AHA/PLMA, respectively). HR changes may partially account for the increased cerebral hemodynamics during PLMA; whereas in AHA probable vasodilatation mediated by hypoxia/hypercapnia is more crucial for the post-arousal hemodynamics. The differences between changes of cerebral hemodynamics and HR may indicate different pathological mechanisms behind these two sleep disorder events.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study

et al. 2016

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“…Besides above possible mechanisms for the development of CVD (and thus stroke), a small study used near-infrared spectroscopy and documented transient cerebral hemodynamic fluctuations with consequent hypoxia accompanying PLMS. 124 Theoretically, these metabolic alterations could lead to small cerebral arteriole damage and subsequent SVD, 8 which is a known risk factor for stroke.…”

Section: Perspectives Of Rls/plms and Cardiovascular Diseasementioning

confidence: 99%

Cardiovascular comorbidity in patients with restless legs syndrome: current perspectives

Vargas-Pérez¹,

Bagai²,

Walters³

2017

JPRLS

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“…These properties, together with portability and relatively low cost of instrumentation [13][14][15] , make NIRS to be a promising tool for long term monitoring local hemodynamic changes in brain and peripheral tissues such as muscle during all night sleep. Accordingly, NIRS has been applied to sleep since the middle of 1990s to assess changes of cerebral hemodynamics between sleep stages [24][25][26] and the transitions of sleep stages [22][23] as well as the effects of sleep disorders on cerebral hemodynamics [27][28][29] .…”

Section: Introductionmentioning

confidence: 99%

Brain and muscle oxygenation monitoring using near-infrared spectroscopy (NIRS) during all-night sleep

Zhang

Khatami

2013

SPIE Proceedings

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The hemodynamic changes during natural human sleep are still not well understood. NIRS is ideally suited for monitoring the hemodynamic changes during sleep due to the properties of local measurement, totally safe application and good tolerance to motion. Several studies have been conducted using NIRS in both normal subjects and patients with various sleep disorders during sleep to characterize the hemodynamic changing patterns during different sleep stages and during different symptoms such as obstructive apneas. Here we assessed brain and muscle oxygenation changes in 7 healthy adults during all-night sleep with combined polysomnography measurement to test the notion if hemodynamic changes in sleep are indeed brain specific. We found that muscle and brain showed similar hemodynamic changes during sleep initiation. A decrease in HbO 2 and tissue oxygenation index (TOI) while an increase in HHb was observed immediately after sleep onset, and an opposite trend was found after transition with progression to deeper slow-wave sleep (SWS) stage. Spontaneous low frequency oscillations (LFO) and very low frequency oscillations (VLFO) were smaller (Levene's test, p<0.05) during SWS compared to light sleep (LS) and rapid-eye-movement (REM) sleep in both brain and muscle. Spectral analysis of the NIRS signals measured from brain and muscle also showed reductions in VLFO and LFO powers during SWS with respect to LS and REM sleep. These results indicate a systemic attenuation rather than local cerebral reduction of spontaneous hemodynamic activity in SWS. A systemic physiological mechanism may exist to regulate the hemodynamic changes in brain and muscle during sleep.

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Periodic leg movements during sleep and cerebral hemodynamic changes detected by NIRS

Cited by 18 publications

References 12 publications

The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study

The Comparisons of Cerebral Hemodynamics Induced by Obstructive Sleep Apnea with Arousal and Periodic Limb Movement with Arousal: A Pilot NIRS Study

Cardiovascular comorbidity in patients with restless legs syndrome: current perspectives

Brain and muscle oxygenation monitoring using near-infrared spectroscopy (NIRS) during all-night sleep

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