Use of cutaneous silent period parameters as a diagnostic indicator in patients with restless legs syndrome-a study in south Indian population

  • Dr Reena Alexander Past Resident, Department of Physiology, Amrita institute of Medical sciences, Kochi, India. Presently Assistant Professor, Department of Physiology, Sree Narayana Institute of Medical Sciences, Kochi, India
  • Dr Saraswathy L Professor Head, Department of Physiology, Amrita Institute of Medical Sciences, Kochi, India
  • Dr Siby Gopinath Professor, Department of Neurology, Amrita institute of Medical sciences, Kochi, Kerala, India
Keywords: Cutaneous silent period, Restless leg Syndrome, Small fiber neuropathy, Willis-Ekbom disease

Abstract

Objective: The objectives of this study were to investigate cutaneous-silent- period (CSP) parameters- CSP latency and CSP duration in patients with ‘Restless legs Syndrome’ and compare it with that of normal healthy controls.

Methods: Thirty patients diagnosed with restless legs syndrome were included in this study. The cutaneous silent period was evoked by electrical stimulation of sural nerve whereby both CSP parameters CSP latency and CSP duration were recorded and analyzed.

Results: The mean latencies of CSP among the thirty RLS patients were 101.95±12.12 while the control group showed 96.23± 9.16. There is a statistically significant high average latency in RLS patients (101.95± 12.12) than control group (96.23± 9.16) with p value=0.044. This study also showed the average CSP duration to be high in RLS patients (42.25± 11.12), when compared to the control group – 36.75± 8.35 (p value=0.035).

Conclusion: While RLS is a common sensorimotor disorder, the diagnosis of RLS is purely clinical and there are no objective tests for the diagnosis. Unfortunately, the awareness is poor among the lay population, general practitioners and even specialists in the Indian subcontinent. The authors feel that the CSP test can be used as an objective method supporting the diagnosis of RLS. Furthermore, we believe that this paper will help create awareness in addition to encouraging more research in this arena from medical personnel in India.

Downloads

Download data is not yet available.

References

Coccagna G, Vetrugno R, Lombardi C, Provini F. Restless legs syndrome: an historical note. Sleep Med. 2004 May;5(3):279-83.

Ekbom KA: Restless legs: a clinical study. Acta Med Scand 1945; 158(suppl):1–122.

Walters AS. Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord. 1995 Sep;10(5):634-42.

Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994 Dec;17(8):739-43.

Rangarajan S, Rangarajan S, D'Souza GA. Restless legs syndrome in an Indian urban population. Sleep Med. 2007 Dec;9(1):88-93. Epub 2007 Sep 6.

Rangarajan S, D'Souza GA. Restless legs syndrome in Indian patients having iron deficiency anemia in a tertiary care hospital. Sleep Med. 2007 Apr;8(3):247-51. Epub 2007 Mar 26.

Angel RW, Hofmann WW, Eppler W. Silent period in patients with parkinsonian rigidity. Neurology. 1966 May;16(5):529-32.

Trenkwalder C, Paulus W, Walters AS. The restless legs syndrome. Lancet Neurol. 2005 Aug;4(8):465-75.

Gupta R, Lahan V, Goel D. Restless Legs Syndrome: a common disorder, but rarely diagnosed and barely treated--an Indian experience. Sleep Med. 2012 Aug;13(7):838-41. doi: https://doi.org/10.1016/j.sleep.2012.03.018. Epub 2012 Jun 14.

Congiu P, Fantini ML, Milioli G, Tacconi P, Figorilli M, Gioi G, Pereira B, Marrosu F, Parrino L, Puligheddu M. F-Wave Duration as a Specific and Sensitive Tool for the Diagnosis of Restless Legs Syndrome/Willis-Ekbom Disease. J Clin Sleep Med 2017 Mar 15; 13(3):369-75.

Isak B, Uluc K, Salcini C, Agan K, Tanridag T, Us O. A neurophysiological approach to the complex organisation of the spine: F-wave duration and the cutaneous silent period in restless legs syndrome. Clin Neurophysiol. 2011 Feb;122(2):383-90. doi: https://doi.org/10.1016/j.clinph.2010.07.005. Epub 2010 Aug 17.

Oz O, Erdoğan C, Yücel M, Akgün H, Kütükçü Y, Gökçil Z, Odabaşı Z. Effect of pramipexole on cutaneous-silent-period parameters in patients with restless legs syndrome. Clin Neurophysiol. 2012 Jan;123(1):154-9. doi: https://doi.org/10.1016/j.clinph.2011.05.027.

Tiric-Campara M, Denislic M, Djelilovic-Vranic J, et al. Cutaneous Silent Period in the Evaluation of Small Nerve Fibres. Med Arch. 2014;68(2):98-101. doi: https://dx.doi.org/10.5455%2Fmedarh.2014.68.98-101.

Uncini A, Kujirai T, Gluck B, Pullman S. Silent period induced by cutaneous stimulation. Electroencephalogr Clin Neurophysiol. 1991 Oct; 81(5):344-52.

Han JK, Oh K, Kim BJ, Koh SB, Kim JY, Park KW, Lee DH. Cutaneous silent period in patients with restless leg syndrome. Clin Neurophysiol. 2007 Aug;118(8):1705-10. Epub 2007 Jun 22.

Polydefkis M, Allen RP, Hauer P, Earley CJ, Griffin JW, McArthur JC. Subclinical sensory neuropathy in late-onset restless legs syndrome. Neurology. 2000 Oct 24;55(8):1115-21.

Gemignani F, Brindani F, Negrotti A, Vitetta F, Alfieri S, Marbini A. Restless legs syndrome and polyneuropathy. Mov Disord. 2006 Aug;21(8):1254-7.

Gladwell SJ, Coote JH. Inhibitory and indirect excitatory effects of dopamine on sympathetic preganglionic neurons in the neonatal rat spinal cord in vitro. Brain Res. 1999 Feb 13;818(2):397-407.

Clemens S, Rye D, Hochman S. Restless legs syndrome: revisiting the dopamine hypothesis from the spinal cord perspective. Neurology. 2006 Jul 11;67(1):125-30.

Garraway SM, Hochman S. Modulatory actions of serotonin, norepinephrine, dopamine, and acetylcholine in spinal cord deep dorsal horn neurons. J Neurophysiol. 2001 Nov;86(5):2183-94.

Use of cutaneous silent period parameters as a diagnostic indicator in patients with restless legs syndrome-a study in south Indian population
CITATION
DOI: 10.17511/ijmrr.2018.i02.07
Published: 2018-02-28
How to Cite
1.
Alexander R, L S, Gopinath S. Use of cutaneous silent period parameters as a diagnostic indicator in patients with restless legs syndrome-a study in south Indian population. Int J Med Res Rev [Internet]. 2018Feb.28 [cited 2024Nov.8];6(2):110-5. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/965
Section
Original Article