Impaired slow oscillation, sleep spindle, and slow oscillation−spindle coordination in patients with idiopathic restless legs syndrome

Kwang Su Cha, Tae Joon Kim, Jin Sun Jun, Jung Ick Byun, Jun Sang Sunwoo, Jung Won Shin, Kyung Hwan Kim, Sang Kun Lee, Ki Young Jung

Research output: Contribution to journalArticle

Abstract

Objectives: Thalamocortical abnormalities have been implicated in the pathophysiology of restless legs syndrome (RLS). We hypothesized that sleep spindle and slow oscillation (SO) activity is impaired in RLS, and that this dysfunction may contribute to sleep disturbance in these patients. To address this issue, we characterized sleep spindle and SO activity in RLS. Methods: Fifteen drug-naive, idiopathic RLS patients (13 female and 2 male) and 15 female healthy controls participated in this study. Nineteen-channel electroencephalograms were obtained during polysomnographic (PSG) recordings. An automated sleep spindle and SO detection algorithm was used to detect sleep spindle (12–16 Hz) and SO (<1 Hz) activity. The quantitative characteristics of sleep spindle and SO activity were investigated. Results: Compared with the healthy controls, in RLS patients, we observed density and power reduction in sleep spindles. In SOs, density reduction and duration increment were shown in RLS patients. In addition, SO−spindle coordination was deficient in RLS as revealed by reduced SO locked spindle power, dispersed and delayed spindle phase, and decreased SO−spindle coupling. Although sleep spindle power was negatively correlated with wake after sleep onset (WASO) time, SO duration was positively correlated with the arousal index in RLS. Conclusions: Our study suggests that sleep disturbances may be mediated by a combined deficit in spindle and SO activity and SO−spindle coordination. The abnormal SO and spindle activity observed in RLS support the notion that thalamocortical abnormalities underlie this condition and may promote disturbed sleep integrity.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalSleep Medicine
Volume66
DOIs
StatePublished - Feb 2020

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Restless Legs Syndrome
Sleep
Arousal
Electroencephalography

Keywords

  • Arousal
  • Restless legs syndrome
  • Sleep disturbance
  • Sleep spindles
  • Slow oscillations
  • Wake after sleep onset

Cite this

Cha, Kwang Su ; Kim, Tae Joon ; Jun, Jin Sun ; Byun, Jung Ick ; Sunwoo, Jun Sang ; Shin, Jung Won ; Kim, Kyung Hwan ; Lee, Sang Kun ; Jung, Ki Young. / Impaired slow oscillation, sleep spindle, and slow oscillation−spindle coordination in patients with idiopathic restless legs syndrome. In: Sleep Medicine. 2020 ; Vol. 66. pp. 139-147.
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abstract = "Objectives: Thalamocortical abnormalities have been implicated in the pathophysiology of restless legs syndrome (RLS). We hypothesized that sleep spindle and slow oscillation (SO) activity is impaired in RLS, and that this dysfunction may contribute to sleep disturbance in these patients. To address this issue, we characterized sleep spindle and SO activity in RLS. Methods: Fifteen drug-naive, idiopathic RLS patients (13 female and 2 male) and 15 female healthy controls participated in this study. Nineteen-channel electroencephalograms were obtained during polysomnographic (PSG) recordings. An automated sleep spindle and SO detection algorithm was used to detect sleep spindle (12–16 Hz) and SO (<1 Hz) activity. The quantitative characteristics of sleep spindle and SO activity were investigated. Results: Compared with the healthy controls, in RLS patients, we observed density and power reduction in sleep spindles. In SOs, density reduction and duration increment were shown in RLS patients. In addition, SO−spindle coordination was deficient in RLS as revealed by reduced SO locked spindle power, dispersed and delayed spindle phase, and decreased SO−spindle coupling. Although sleep spindle power was negatively correlated with wake after sleep onset (WASO) time, SO duration was positively correlated with the arousal index in RLS. Conclusions: Our study suggests that sleep disturbances may be mediated by a combined deficit in spindle and SO activity and SO−spindle coordination. The abnormal SO and spindle activity observed in RLS support the notion that thalamocortical abnormalities underlie this condition and may promote disturbed sleep integrity.",
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author = "Cha, {Kwang Su} and Kim, {Tae Joon} and Jun, {Jin Sun} and Byun, {Jung Ick} and Sunwoo, {Jun Sang} and Shin, {Jung Won} and Kim, {Kyung Hwan} and Lee, {Sang Kun} and Jung, {Ki Young}",
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Impaired slow oscillation, sleep spindle, and slow oscillation−spindle coordination in patients with idiopathic restless legs syndrome. / Cha, Kwang Su; Kim, Tae Joon; Jun, Jin Sun; Byun, Jung Ick; Sunwoo, Jun Sang; Shin, Jung Won; Kim, Kyung Hwan; Lee, Sang Kun; Jung, Ki Young.

In: Sleep Medicine, Vol. 66, 02.2020, p. 139-147.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impaired slow oscillation, sleep spindle, and slow oscillation−spindle coordination in patients with idiopathic restless legs syndrome

AU - Cha, Kwang Su

AU - Kim, Tae Joon

AU - Jun, Jin Sun

AU - Byun, Jung Ick

AU - Sunwoo, Jun Sang

AU - Shin, Jung Won

AU - Kim, Kyung Hwan

AU - Lee, Sang Kun

AU - Jung, Ki Young

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Y1 - 2020/2

N2 - Objectives: Thalamocortical abnormalities have been implicated in the pathophysiology of restless legs syndrome (RLS). We hypothesized that sleep spindle and slow oscillation (SO) activity is impaired in RLS, and that this dysfunction may contribute to sleep disturbance in these patients. To address this issue, we characterized sleep spindle and SO activity in RLS. Methods: Fifteen drug-naive, idiopathic RLS patients (13 female and 2 male) and 15 female healthy controls participated in this study. Nineteen-channel electroencephalograms were obtained during polysomnographic (PSG) recordings. An automated sleep spindle and SO detection algorithm was used to detect sleep spindle (12–16 Hz) and SO (<1 Hz) activity. The quantitative characteristics of sleep spindle and SO activity were investigated. Results: Compared with the healthy controls, in RLS patients, we observed density and power reduction in sleep spindles. In SOs, density reduction and duration increment were shown in RLS patients. In addition, SO−spindle coordination was deficient in RLS as revealed by reduced SO locked spindle power, dispersed and delayed spindle phase, and decreased SO−spindle coupling. Although sleep spindle power was negatively correlated with wake after sleep onset (WASO) time, SO duration was positively correlated with the arousal index in RLS. Conclusions: Our study suggests that sleep disturbances may be mediated by a combined deficit in spindle and SO activity and SO−spindle coordination. The abnormal SO and spindle activity observed in RLS support the notion that thalamocortical abnormalities underlie this condition and may promote disturbed sleep integrity.

AB - Objectives: Thalamocortical abnormalities have been implicated in the pathophysiology of restless legs syndrome (RLS). We hypothesized that sleep spindle and slow oscillation (SO) activity is impaired in RLS, and that this dysfunction may contribute to sleep disturbance in these patients. To address this issue, we characterized sleep spindle and SO activity in RLS. Methods: Fifteen drug-naive, idiopathic RLS patients (13 female and 2 male) and 15 female healthy controls participated in this study. Nineteen-channel electroencephalograms were obtained during polysomnographic (PSG) recordings. An automated sleep spindle and SO detection algorithm was used to detect sleep spindle (12–16 Hz) and SO (<1 Hz) activity. The quantitative characteristics of sleep spindle and SO activity were investigated. Results: Compared with the healthy controls, in RLS patients, we observed density and power reduction in sleep spindles. In SOs, density reduction and duration increment were shown in RLS patients. In addition, SO−spindle coordination was deficient in RLS as revealed by reduced SO locked spindle power, dispersed and delayed spindle phase, and decreased SO−spindle coupling. Although sleep spindle power was negatively correlated with wake after sleep onset (WASO) time, SO duration was positively correlated with the arousal index in RLS. Conclusions: Our study suggests that sleep disturbances may be mediated by a combined deficit in spindle and SO activity and SO−spindle coordination. The abnormal SO and spindle activity observed in RLS support the notion that thalamocortical abnormalities underlie this condition and may promote disturbed sleep integrity.

KW - Arousal

KW - Restless legs syndrome

KW - Sleep disturbance

KW - Sleep spindles

KW - Slow oscillations

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DO - 10.1016/j.sleep.2019.09.021

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