Sleep symptoms, including excessive sleepiness, are frequently reported by patients with functional motor disorders (FMD). We aimed to classify the comorbid sleep disorders in FMD, and to investigate the relationship between subjective sleepiness and objective measures of hypersomnia, comparing them with data from people with central hypersomnia. A total of 37 patients (mean [SD] age 46.4 [11.2] years) with clinically definite FMD, and 17 patients (mean [SD] age 41.1 [11.6] years) with central hypersomnia underwent structured medical and sleep history, neurological examination, polysomnography, multiple sleep latency test (MSLT), and questionnaires assessing sleepiness, fatigue, and depression. In all, 23 patients with FMD (62%) reported excessive daytime sleepiness. Evidence of specific sleep disorders was identified in our cohort, with 35% having restless legs syndrome; 49% obstructive sleep apnea; and 8% periodic limb movements in sleep; however, the presence of these disorders was not correlated with subjective sleepiness. Patients with FMD with self-reported sleepiness reported higher fatigue (p = 0.002), depression (p = 0.002), and had longer sleep latencies in the MSLT (p < 0.001) compared to the patients with central hypersomnia. No correlation was found between subjective and objective sleepiness in either group. Fatigue positively correlated with self-reported sleepiness in patients with FMD (p < 0.001). This study did not find objective correlates of increased sleepiness in patients with FMD. While sleep abnormalities were found to be common in FMD, they were not correlated with self-reports of excessive sleepiness. Positive correlations between self-reported sleepiness and fatigue support the current unified model of non-motor symptoms in FMD.

• Klíčová slova
• functional motor disorder, multiple sleep latency test (MSLT), polysomnography, restless legs syndrome, sleep apnea, sleepiness,
• MeSH
• deprese epidemiologie   patofyziologie   MeSH
• dospělí MeSH
• komorbidita * MeSH
• lidé středního věku MeSH
• lidé MeSH
• periodické pohyby končetinami ve spánku epidemiologie   patofyziologie   MeSH
• polysomnografie * MeSH
• poruchy nadměrné spavosti * epidemiologie   patofyziologie   MeSH
• poruchy spánku a bdění epidemiologie   patofyziologie   MeSH
• průzkumy a dotazníky MeSH
• somnolence MeSH
• spánková latence fyziologie   MeSH
• syndrom neklidných nohou patofyziologie   epidemiologie   MeSH
• únava patofyziologie   epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVE: The restless legs syndrome (RLS) is characterized by sensory-motor symptoms which usually occur predominantly at rest in the evening and at night. It is assumed that this circadian rhythm is caused by low dopamine levels in the evening. Yet, it has never been investigated whether RLS patients show diurnal variations in cognitive functions modulated by dopamine and what neurophysiological and functional neuroanatomical processes underlie such modulations. METHODS: We used a Simon task combined with EEG and source localization to investigate whether top-down response selection and/or automatic visuo-motor priming are subject to diurnal changes in RLS patients, as compared to matched healthy controls. RESULTS: We found that RLS patients showed better task performance due to reduced visuo-motor priming in the evening, as reflected by smaller early lateralized readiness potential (e-LRP) amplitudes and decreased activation of the superior parietal cortex and premotor cortex. Top-down response selection and early attentional processing were unaffected by RLS. CONCLUSIONS: Counterintuitively, RLS patients show enhanced task performance in the evening, i.e. when experiencing dopaminergic deficiency. Yet, this may be explained by deficits in visuo-motor priming that lead to reduced false response tendencies. SIGNIFICANCE: This study reveals a counterintuitive circadian variation of cognitive functions in RLS patients.

• Klíčová slova
• Circadian rhythm, Lateralized readiness potential, Premotor cortex, Restless legs syndrome, Superior parietal cortex, Visuo-motor priming,
• MeSH
• cirkadiánní rytmus * MeSH
• dopamin metabolismus   MeSH
• elektroencefalografie MeSH
• kognice MeSH
• lidé středního věku MeSH
• lidé MeSH
• opakované seznamování se skutečností * MeSH
• psychomotorický výkon * MeSH
• senioři MeSH
• somatosenzorické korové centrum patofyziologie   MeSH
• studie případů a kontrol MeSH
• syndrom neklidných nohou metabolismus   patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• dopamin MeSH

The circadian variation of sensory and motor symptoms with increasing severity in the evening and at night is a key diagnostic feature/symptom of the restless legs syndrome (RLS). Even though many neurological diseases have shown a strong nexus between motor and cognitive symptoms, it has remained unclear whether cognitive performance of RLS patients declines in the evening and which neurophysiological mechanisms are affected by the circadian variation. In the current study, we examined daytime effects (morning vs. evening) on cognitive performance in RLS patients (n = 33) compared to healthy controls (n = 29) by analyzing flanker interference effects in combination with EEG and source localization techniques. RLS patients showed larger flanker interference effects in the evening than in the morning (p = .023), while healthy controls did not display a comparable circadian variation. In line with this, the neurophysiological data showed smaller N1 amplitudes in RLS patients compared to controls in the interfering task condition in the evening (p = .042), but not in the morning. The results demonstrate diurnal cognitive changes in RLS patients with intensified impairments in the evening. It seems that not all dopamine-regulated cognitive processes are altered in RLS and thus show daytime-dependent impairments. Instead, the daytime-related cognitive impairment emerges from attentional selection processes within the extra-striate visual cortex, but not from later cognitive processes such as conflict monitoring and response selection.

• Klíčová slova
• Attentional selection, Circadian variation, Cognition, EEG, Flanker interference effect, Restless legs syndrome (RLS),
• MeSH
• cirkadiánní rytmus fyziologie   MeSH
• dospělí MeSH
• elektroencefalografie MeSH
• kognice fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pozornost fyziologie   MeSH
• senioři MeSH
• syndrom neklidných nohou patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Narcolepsy-cataplexy (N-C) is a focal neurodegenerative disease with a genetic predisposition and autoimmune etiology; the pathogenesis of narcolepsy without cataplexy (Nw/oC) is less clear. One hundred and forty eight patients underwent clinical face-to face interviews, polysomnography, multiple sleep latency testing and HLA-DQB1*0602 typing. The cohort was divided into four age groups: children and adolescents under 19 years (N = 31), adults aged 20-39 years (N = 51), 40-59 years (N = 28) and over 60 years (N = 38). N-C was found in 93 adults (79.5 %) compared with 16 pediatric patients (51.6 %) (p < 0.01), suggesting that at least some of the children were candidates for developing cataplexy in the future. Statistical evaluation showed an increasing age-related proportion of associated sleep disorders-obstructive sleep apnea, periodic leg movements and restless leg syndrome (p < 0.001). Nw/oC patients showed sleep comorbidities less frequently than N-C group. A close connection with N-C was found particularly in REM behavior disorder (RBD) (p < 0.05). RBD affected a third of the patients in the youngest as well as in the oldest groups. However, association with other sleep disorders had no significant effect on nocturnal sleep (with the exception of obstructive sleep apnea), and the sleep comorbidities under study had no noticeable effect on daytime sleepiness.

• MeSH
• dítě MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• narkolepsie diagnóza   epidemiologie   patofyziologie   MeSH
• polysomnografie metody   MeSH
• porucha chování v REM spánku diagnóza   epidemiologie   patofyziologie   MeSH
• poruchy spánku a bdění diagnóza   epidemiologie   patofyziologie   MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stadia spánku fyziologie   MeSH
• syndrom neklidných nohou diagnóza   epidemiologie   patofyziologie   MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUND: Obstructive sleep apnoea (OSA) is a condition leading to excessive daytime sleepiness. The aim of the study was a) to study course of daytime sleepiness in patients with OSA and b) to find the most important nocturnal polysomnography parameters influencing daytime sleepiness in OSA. METHODS: The cohort consisted of forty-five patients (6 women, 39 men) diagnosed with OSA. All patients underwent polysomnography, Multiple Sleep Latency Test (MSLT) and rated subjectively their daytime tendency to sleep with the Epworth Sleepiness Scale. RESULTS: Sleep latency was significantly longer at 15:00 and at 17:00 hours compared to previous tests. A significant negative correlation was found between the mean of the MSLT sleep latency and a number of awakenings, the apnoea/hypopnoea index and oxygen desaturation index values. CONCLUSIONS: The study showed the sleep latency prolongation at 15:00 and 17:00 hours respectively and confirmed connection of excessive daytime sleepiness to fragmentation of nocturnal sleep and OSA severity.

• MeSH
• cirkadiánní rytmus fyziologie   MeSH
• dospělí MeSH
• kardiovaskulární nemoci epidemiologie   MeSH
• kohortové studie MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• obstrukční spánková apnoe diagnóza   epidemiologie   patofyziologie   MeSH
• polysomnografie MeSH
• porucha chování v REM spánku epidemiologie   patofyziologie   MeSH
• poruchy nadměrné spavosti epidemiologie   patofyziologie   MeSH
• senioři MeSH
• spánek fyziologie   MeSH
• stadia spánku fyziologie   MeSH
• syndrom neklidných nohou epidemiologie   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The restless legs syndrome (RLS) is a sensorimotor disorder characterised by an intense urge to move the legs and sometimes also other parts of the body, and accompanied by a marked sense of discomfort or pain in the affected body parts. This urge has a circadian pattern - it is most pronounced in the evening or during the night. RLS symptoms are relieved by movement. The pathophysiology of RLS is related to dopamine transmission insufficiency, low iron storage in substantia nigra neurons, and spinal cord dysfunction. RLS is idiopathic or secondary (usually associated with iron deficiency, end-stage renal failure, pregnancy and spinal lesions). One half of the patients with idiopathic RLS have positive family history of RLS. RLS is curable, though the choice of therapy and proper dosage titration may take a long time, and though the therapy may sometimes have to be changed owing to augmentation. The most important pharmacologic treatment used in RLS includes L-DOPA, dopamine agonists, opiates, anticonvulsants and benzodiazepines. Therapy improves significantly the condition in long-term at least in 80% of RLS patients.

• MeSH
• lidé MeSH
• syndrom neklidných nohou * diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Terguride as a partial D2-receptors agonist seems suitable for treatment of restless legs syndrome (RLS). METHODS: Nine RLS patients without previous dopaminergic therapy received a daily dose of terguride (0.25 mg) 29.9+/-16.9 (SD) days. RESULTS: Two patients enrolled in the study failed to turn up for a successive check up. The seven subjects who were re-examined complied with the therapy. Their RLS symptoms improved (as measured on the International RLS intensity scale), decreasing from 24.3+/-5.3 to 14+/-4.7 (p=0.014). However, the terguride treatment did not significantly alter the daytime sleepiness or the subjective duration of nocturnal sleep. The daily dose was doubled in three patients who reported insufficient RLS improvement. One of the three patients later reported augmentation.

• MeSH
• agonisté dopaminu aplikace a dávkování   terapeutické užití   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• lisurid aplikace a dávkování   analogy a deriváty   terapeutické užití   MeSH
• receptory dopaminu D2 agonisté   MeSH
• sebezhodnocení (psychologie) MeSH
• senioři MeSH
• spánek MeSH
• stadia spánku účinky léků   MeSH
• syndrom neklidných nohou farmakoterapie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• agonisté dopaminu MeSH
• dironyl MeSH Prohlížeč
• lisurid MeSH
• receptory dopaminu D2 MeSH