Neurophysiological correlates of sleep leg movements in acute spinal cord injury

Raffaele Ferri, Paola Proserpio, Francesco Rundo, Andrea Lanza, Katrina Sambusida, Tiziana Redaelli, Fabrizio De Carli, Lino Nobili

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study was to analyze the periodicity of leg movement activity emerging during sleep in a group of patients with spinal cord injury and to evaluate their pathophysiological features. Methods: Twenty patients (16 males, mean age 34.0. years) with traumatic spinal cord lesions were recruited (5 cervical, 15 thoracic; 16 level A and 4 level B at the American Spinal Injury Association impairment scale). Periodicity of sleep leg movements was analyzed; electroencephalographic spectral analysis and heart rate were evaluated for 20. s preceding and 30. s following the onset of leg movements. Results: Periodic leg movements during sleep (PLMS) index >5/h was found in only 4 patients and only 2 of these had PLMS index >15/h. Eleven patients (group I) did not show any increase in heart rate related to the occurrence of leg movements while the remaining 9 did (group II). Two patients in each group had American Spinal Injury Association impairment level B; 5 patients of group I and none of group II had cervical lesions while 6 patients of group I and all 9 of group II had thoracic lesions. Only 2 patients in group I presented clearly periodic leg movements during sleep and PLMS index >15/h. Electroencephalographic delta, alpha and beta bands around leg movements increased clearly in group II while the changes in group I were very limited or absent. Conclusion: Leg movements during sleep are recorded in spinal cord injury patients with completely absent volitional activity in their lower limb but they show clear periodicity only in a small subgroup of them. Significance: The disconnection from higher nervous structures, in patients with spinal cord injury might favor the appearance of leg movements due to the activity of spinal generators not inhibited by higher influences; correlated autonomic and electroencephalographic changes can be absent. This motor activity might assume the periodic character when a genetic predisposition is present.

Original languageEnglish
Pages (from-to)333-338
Number of pages6
JournalClinical Neurophysiology
Volume126
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

Fingerprint

Spinal Cord Injuries
Leg
Sleep
Periodicity
Thorax
Heart Rate
Genetic Predisposition to Disease
Lower Extremity
Spinal Cord
Motor Activity

Keywords

  • Heart rate
  • Leg movements
  • Periodicity index
  • Sleep
  • Spectral EEG analysis
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)
  • Sensory Systems
  • Medicine(all)

Cite this

Neurophysiological correlates of sleep leg movements in acute spinal cord injury. / Ferri, Raffaele; Proserpio, Paola; Rundo, Francesco; Lanza, Andrea; Sambusida, Katrina; Redaelli, Tiziana; De Carli, Fabrizio; Nobili, Lino.

In: Clinical Neurophysiology, Vol. 126, No. 2, 01.02.2015, p. 333-338.

Research output: Contribution to journalArticle

Ferri, R, Proserpio, P, Rundo, F, Lanza, A, Sambusida, K, Redaelli, T, De Carli, F & Nobili, L 2015, 'Neurophysiological correlates of sleep leg movements in acute spinal cord injury', Clinical Neurophysiology, vol. 126, no. 2, pp. 333-338. https://doi.org/10.1016/j.clinph.2014.05.016
Ferri, Raffaele ; Proserpio, Paola ; Rundo, Francesco ; Lanza, Andrea ; Sambusida, Katrina ; Redaelli, Tiziana ; De Carli, Fabrizio ; Nobili, Lino. / Neurophysiological correlates of sleep leg movements in acute spinal cord injury. In: Clinical Neurophysiology. 2015 ; Vol. 126, No. 2. pp. 333-338.
@article{eda466dffd69461f8d25b80aa3d88c7b,
title = "Neurophysiological correlates of sleep leg movements in acute spinal cord injury",
abstract = "Objective: The objective of this study was to analyze the periodicity of leg movement activity emerging during sleep in a group of patients with spinal cord injury and to evaluate their pathophysiological features. Methods: Twenty patients (16 males, mean age 34.0. years) with traumatic spinal cord lesions were recruited (5 cervical, 15 thoracic; 16 level A and 4 level B at the American Spinal Injury Association impairment scale). Periodicity of sleep leg movements was analyzed; electroencephalographic spectral analysis and heart rate were evaluated for 20. s preceding and 30. s following the onset of leg movements. Results: Periodic leg movements during sleep (PLMS) index >5/h was found in only 4 patients and only 2 of these had PLMS index >15/h. Eleven patients (group I) did not show any increase in heart rate related to the occurrence of leg movements while the remaining 9 did (group II). Two patients in each group had American Spinal Injury Association impairment level B; 5 patients of group I and none of group II had cervical lesions while 6 patients of group I and all 9 of group II had thoracic lesions. Only 2 patients in group I presented clearly periodic leg movements during sleep and PLMS index >15/h. Electroencephalographic delta, alpha and beta bands around leg movements increased clearly in group II while the changes in group I were very limited or absent. Conclusion: Leg movements during sleep are recorded in spinal cord injury patients with completely absent volitional activity in their lower limb but they show clear periodicity only in a small subgroup of them. Significance: The disconnection from higher nervous structures, in patients with spinal cord injury might favor the appearance of leg movements due to the activity of spinal generators not inhibited by higher influences; correlated autonomic and electroencephalographic changes can be absent. This motor activity might assume the periodic character when a genetic predisposition is present.",
keywords = "Heart rate, Leg movements, Periodicity index, Sleep, Spectral EEG analysis, Spinal cord injury",
author = "Raffaele Ferri and Paola Proserpio and Francesco Rundo and Andrea Lanza and Katrina Sambusida and Tiziana Redaelli and {De Carli}, Fabrizio and Lino Nobili",
year = "2015",
month = "2",
day = "1",
doi = "10.1016/j.clinph.2014.05.016",
language = "English",
volume = "126",
pages = "333--338",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Neurophysiological correlates of sleep leg movements in acute spinal cord injury

AU - Ferri, Raffaele

AU - Proserpio, Paola

AU - Rundo, Francesco

AU - Lanza, Andrea

AU - Sambusida, Katrina

AU - Redaelli, Tiziana

AU - De Carli, Fabrizio

AU - Nobili, Lino

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Objective: The objective of this study was to analyze the periodicity of leg movement activity emerging during sleep in a group of patients with spinal cord injury and to evaluate their pathophysiological features. Methods: Twenty patients (16 males, mean age 34.0. years) with traumatic spinal cord lesions were recruited (5 cervical, 15 thoracic; 16 level A and 4 level B at the American Spinal Injury Association impairment scale). Periodicity of sleep leg movements was analyzed; electroencephalographic spectral analysis and heart rate were evaluated for 20. s preceding and 30. s following the onset of leg movements. Results: Periodic leg movements during sleep (PLMS) index >5/h was found in only 4 patients and only 2 of these had PLMS index >15/h. Eleven patients (group I) did not show any increase in heart rate related to the occurrence of leg movements while the remaining 9 did (group II). Two patients in each group had American Spinal Injury Association impairment level B; 5 patients of group I and none of group II had cervical lesions while 6 patients of group I and all 9 of group II had thoracic lesions. Only 2 patients in group I presented clearly periodic leg movements during sleep and PLMS index >15/h. Electroencephalographic delta, alpha and beta bands around leg movements increased clearly in group II while the changes in group I were very limited or absent. Conclusion: Leg movements during sleep are recorded in spinal cord injury patients with completely absent volitional activity in their lower limb but they show clear periodicity only in a small subgroup of them. Significance: The disconnection from higher nervous structures, in patients with spinal cord injury might favor the appearance of leg movements due to the activity of spinal generators not inhibited by higher influences; correlated autonomic and electroencephalographic changes can be absent. This motor activity might assume the periodic character when a genetic predisposition is present.

AB - Objective: The objective of this study was to analyze the periodicity of leg movement activity emerging during sleep in a group of patients with spinal cord injury and to evaluate their pathophysiological features. Methods: Twenty patients (16 males, mean age 34.0. years) with traumatic spinal cord lesions were recruited (5 cervical, 15 thoracic; 16 level A and 4 level B at the American Spinal Injury Association impairment scale). Periodicity of sleep leg movements was analyzed; electroencephalographic spectral analysis and heart rate were evaluated for 20. s preceding and 30. s following the onset of leg movements. Results: Periodic leg movements during sleep (PLMS) index >5/h was found in only 4 patients and only 2 of these had PLMS index >15/h. Eleven patients (group I) did not show any increase in heart rate related to the occurrence of leg movements while the remaining 9 did (group II). Two patients in each group had American Spinal Injury Association impairment level B; 5 patients of group I and none of group II had cervical lesions while 6 patients of group I and all 9 of group II had thoracic lesions. Only 2 patients in group I presented clearly periodic leg movements during sleep and PLMS index >15/h. Electroencephalographic delta, alpha and beta bands around leg movements increased clearly in group II while the changes in group I were very limited or absent. Conclusion: Leg movements during sleep are recorded in spinal cord injury patients with completely absent volitional activity in their lower limb but they show clear periodicity only in a small subgroup of them. Significance: The disconnection from higher nervous structures, in patients with spinal cord injury might favor the appearance of leg movements due to the activity of spinal generators not inhibited by higher influences; correlated autonomic and electroencephalographic changes can be absent. This motor activity might assume the periodic character when a genetic predisposition is present.

KW - Heart rate

KW - Leg movements

KW - Periodicity index

KW - Sleep

KW - Spectral EEG analysis

KW - Spinal cord injury

UR - http://www.scopus.com/inward/record.url?scp=84921611456&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921611456&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2014.05.016

DO - 10.1016/j.clinph.2014.05.016

M3 - Article

C2 - 24947594

AN - SCOPUS:84921611456

VL - 126

SP - 333

EP - 338

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

IS - 2

ER -