Comparing Periodic Limb Movements in Sleep in Subjects with and without Waking Paretic/Plegic Limbs (I3-2.002)

OBJECTIVE: Compare the prevalence of polysomnographically documented periodic limb movements in sleep (PLMS) in subjects with and without waking paretic/plegic limbs. BACKGROUND: Our research and anecdotal reports of stroke and spinal cord injury reveals some subjects without waking clinical or electromyographic (EMG) motor activity have significant PLMS and body movements in sleep, whereas normal controls generally show a decrease in body movements during sleep. These findings indicate despite clinical paralysis neuronal connections still exist between cortex/brainstem sleep centers and spinal movement centers, and aggressive physical/functional electrical stimulation therapies may allow regeneration of additional neural signals below injury levels and some recovery of diurnal movement. DESIGN/METHODS: Over 4 years, as part of an IRB approved study, we reviewed 7061 consecutively encountered PSGs from the University of Iowa Sleep Center’s data bank and compared the proportion with PLMS (using the diagnostic criteria > or = to 15 events/hour of sleep) between groups with waking lower extremity paresis/plegia versus without waking lower extremity paresis/plegia, using Pearson chi-square test. RESULTS: PLMS were found in 810 of 7061 patients (11.5%), 14 of 97 individuals with stroke (14.4%), and in 11 of 50 subjects with paralysis/paresis (22.0%). A significant association of PLMS was found in those with paralysis/paresis (11/50; 22%) versus 799/6212 (11.4%) in those without paralysis/paresis (p=0.019). CONCLUSIONS: In this study, PLMS were more prevalent in subjects with waking paralysis/paresis compared to those without waking paralysis/paresis. We intend to meticulously analyze these PLMS and identify, qualify and quantify unique elements that more accurately approximate surviving neuronal connections between cortex/brainstem sleep and spinal movement centers, to improve prognostication and selection of paralyzed patients regarding aggressive physical/functional electrical stimulation therapies. Disclosure: Dr. Dyken has received research support for a study concerning Obstructive Sleep Apnea. Dr. Zimmerman has nothing to disclose. Dr. Im has nothing to disclose. Dr. Lin-Dyken has nothing to disclose. Dr. Glenn has nothing to disclose. Dr. Blumberg has nothing to disclose. Dr. Rodnitzky has received personal compensation in an editorial capacity for Parkinsonism & Related Disorders. Dr. Rodnitzky holds stock and/or stock options in Johnson & Johnson. Dr. Sokoloff has nothing to disclose.