Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson's disease

Nomura, Takashi; Inoue, Yuichi; Miyake, Masahiro; Yasui, Kenichi; Nakashima, Kenichiro

doi:10.1002/mds.20734

Cited by 135 publications

(118 citation statements)

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“…Ondo et al 13 and Gomez et al 14 had found prevalence rates of 20.8% and 21.9%, respectively. Although, Nomura et al 15 and Krishnan et al 16 were not able to replicate these findings in their series of PD patients estimating prevalence rates of 12% and 7.9%, respectively. The higher prevalence noted among our group of PD patients may corroborate for the hypotheses of similar pathology between RLS and PD.…”

Section: Discussionmentioning

confidence: 86%

“…In an Indian survey 16 , they reported a significant difference of mean age between PD patients with and without RLS (positive RLS: 63.70±7.8 years; negative RLS: 57.37±10.04 years; p=0.05). Nomura and associates 15 , however, concluded that PD patients without RLS seemed to be younger that those with RLS (positive RLS: 59.7±2.7 years; negative RLS: 70.1±0.8 years; p=0.0001).…”

Section: Discussionmentioning

confidence: 94%

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Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations

Guerreiro

Nishikawa

Ferreira

et al. 2010

Arq. Neuro-Psiquiatr.

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Restless legs syndrome (RLS) is a neurological disorder that responds to dopaminergic drugs, indicating a common pathophysiology with Parkinson's disease (PD). The prevalence of RLS was estimated in a group of PD patients and its clinical and biochemical characteristics were analysed. Forty-eight patients with PD were evaluated into two groups, with and without RLS. Clinical characteristics assessed in both groups were age, gender, duration of PD, Hoehn and Yahr, and Schwab and England scales. Laboratory variables such as hemoglobin, s-iron, s-ferritin and creatinine were obtained. The prevalence of RLS was 18.75%. No significant differences regarding clinical variables and biochemical parameters were observed. The high prevalence of RLS found in PD patients suggests the concept of a common etiological link and it seems that secondary causes did not play a central role in the pathophysiology of RLS in this group of parkinsonian patients. Key words: restless legs syndrome, Parkinson's disease, prevalence, ferritin.Síndrome das pernas inquietas na doença de Parkinson: características clínicas e correlações bioquímicas RESUMO A síndrome das pernas inquietas (SPI) é um distúrbio sensitivo-motor que responde aos agentes dopaminérgicos, demonstrando uma possível semelhança fisiopatológica com a doença de Parkinson (DP). Foi avaliada a prevalência da SPI em um grupo de pacientes com DP e suas características clínicas e laboratoriais. Quarenta e oito pacientes diagnosticados com DP foram divididos em dois grupos: com e sem SPI. Características clínicas como idade, sexo, duração da DP, escalas de Hoehn e Yahr, e Schwab e England e achados bioquímicos como hemoglobina, ferro sérico, ferritina sérica e creatinina foram obtidos. A freqüência da SPI foi de 18,75%. Não se observaram diferenças estatisticamente significativas quanto às características clínicas e aos achados bioquímicos. A alta prevalência de SPI encontrada em pacientes com DP sugere associação entre essas duas doenças. É provável que causas secundárias não exerçam papel central na fisiopatologia da SPI nesse grupo de pacientes parkinsonianos. Palavras-chave: síndrome das pernas inquietas, doença de Parkinson, prevalência, ferritina.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 94%

Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations

Guerreiro

Nishikawa

Ferreira

et al. 2010

Arq. Neuro-Psiquiatr.

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“…This is in accord with other studies and confirms that the vast majority of PD patients develop RLS after onset of PD and most likely after the start of dopaminergic treatment. 4,24,25 Further hypotheses on RLS in PD include the effects of chronic dopaminergic medication. Angelini et al, 26 using data published by Salas et al, 27 suggested that PD, owing to its deficient dopaminergic neurotransmission, could also involve the A11 dopaminergic diencephalon-spinal pathway and thus represent a predisposing condition.…”

Section: Discussionmentioning

confidence: 99%

Serum Ferritin Levels in Parkinson's Disease Patients with and without Restless Legs Syndrome

Muntean

Sixel‐Döring

Trenkwalder

2015

Movement Disord Clin Pract

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Background: The frequency of RLS in Parkinson's disease (PD) patients has been reported to be between 10% and 26%. Several hypotheses have sought to link these two diseases; however, the pathophysiology of RLS in PD patients has yet to be completely defined. Many patients with idiopathic RLS have low serum ferritin levels, which negatively influence RLS symptomatology. Our objective was to investigate the role of iron deficiency in PD patients with and without RLS. Methods: We consecutively included 42 PD inpatients undergoing pharmacological treatment. Patients with anemia, renal insufficiency, or polyneuropathy were excluded from the study. The control group consisted of 42 PD inpatients without RLS (PD-nonRLS), matched for age and severity of PD. RLS was diagnosed clinically according to diagnostic criteria. Serum ferritin levels were measured at admission for all patients. Results: Mean serum ferritin values were 142.20 AE 91.17 ng/dL for PD patients with RLS (PD+RLS) and 160.65 AE 142.57 ng/dL in PD-nonRLS (P = 0.704). There was no difference concerning the total dopaminergic dose (levodopa equivalent dose) between PD+RLS and PD-nonRLS patients (828.22 AE 389.02 vs. 775.32 AE 324.69 mg; P = 0.501). The frequency of dopamine agonist (DA) use did not differ between the two groups (P = 0.306). Conclusions: There were no significant differences in serum ferritin levels between PD+RLS and PD-nonRLS in our study. This suggests a different pathophysiology of RLS in PD patients, where iron deficiency is not necessarily observed. DA use was not found to be associated with the occurrence of RLS symptoms.The relationship between RLS and Parkinson's disease (PD) is controversial. Some studies have shown a higher prevalence of RLS in PD patients, compared to controls, whereas others have failed to demonstrate a significant difference. 1 Although the essential diagnostic criteria for RLS 2 have not yet been validated in PD patients, approximately 10% to 26% of PD patients suffer from RLS-like symptoms, 3-5 often years after manifestation of PD motor symptoms. 4 Other PD patients may develop RLS after successful DBS, when dopaminergic treatment is reduced. 6 A link between RLS and PD has been suggested. Both conditions respond well to dopaminergic treatment and are aggravated by dopaminergic antagonists. 7 They are both associated with periodic limb movements in sleep, which are improved with dopaminergic treatment, especially dopamine agonists. 8,9 However, whereas PD patients with (PD+RLS) and without RLS (PD-nonRLS) show increased echogenicity of the SNc on midbrain sonography (supporting the hypothesis of increased iron concentration), patients with idiopathic RLS are often identified with hypoechogenicity (supporting the hypothesis of decreased iron concentration). This suggests a different underlying pathogenesis, 10,11 probably related to iron storage and transport as well as to brain iron concentrations. Iron and ferritin levels in the cerebrospinal fluid have been found to be reduced in patients with iR...

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“…The RLS frequency for IPD patients in the present study was 10.0%, which is lower than the 20.8% reported by Ondo et al, 28 and closer to the 12% prevalence rate reported for Japan. 29 Ondo et al 28 reported that PD might be a risk factor for RLS and that a secondary RLS could occur after the onset of PD. Our results indicate that RLS is not necessarily associated with the Lewy body pathology that corresponds to PAF.…”

Section: Discussionmentioning

confidence: 99%

Frequent Nocturnal Vocalization in Pure Autonomic Failure

et al. 2008

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Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson's disease

Cited by 135 publications

References 23 publications

Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations

Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations

Serum Ferritin Levels in Parkinson's Disease Patients with and without Restless Legs Syndrome

Frequent Nocturnal Vocalization in Pure Autonomic Failure

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