Restless legs syndrome and periodic leg movements in patients with movement disorders: Specific considerations

Högl, Birgit; Stefani, Ambra

doi:10.1002/mds.26929

Cited by 57 publications

(38 citation statements)

References 189 publications

(219 reference statements)

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“…Several clinical conditions in patients with PD are known to mimic symptoms of RLS/WED, such as motor fluctuation, akathisia, fatigue, pain related to PD and beginning of the “off” period, factors that may be confusing to less experienced assessors and are not identified in assessments performed using questionnaires. Recently, Gjerstad et al [18] demonstrated that after exclusion of mimics there occurs a significant reduction in frequency of RLS in PD patients [31]. The frequency of the RLS/WED in PD patients found in our study was greater than that found in the general population of Brazilian patients [32], suggesting the existence of a pathophysiology common to both diseases.…”

Section: Discussioncontrasting

confidence: 56%

“…It is possible that dopaminergic neurons from the nigrostriatal pathway, related to motor symptoms of PD, degenerate in parallel with the descending neurons of the diencephalic-spinal pathways, related to the symptoms of RLS/WED [33]. Another possible explanation could be related to dopaminergic overstimulation secondary of a long time dopaminergic treatment in susceptible individuals [31]. Finally, it is possible that our high RLS prevalence was related to clinical confounders generating false positive patients.…”

Section: Discussionmentioning

confidence: 99%

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High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life

et al. 2017

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Objectives: To determine the frequency of major sleep disorders in patients with Parkinson’s disease (PD), diagnosed according to the third international classification of sleep disorders, and assess the relationship of those disorders with the quality of life. Methods: A cross-sectional study was performed involving 88 consecutive patients with PD from outpatient clinic. Participants were subjected to clinical interviews, assessment using standardized scales (Epworth Sleepiness Scale, PD Questionnaire, Pittsburgh sleep quality index (PSQI) and, for individuals with a diagnosis of RLS/WED, International RLS/WED grading scale), and video-polysomnography. Results: We observed sleep disorders in 96.5% of the participants, with REM-sleep behavior disorder found in 62.5%, obstructive sleep apnea in 62.5%, insomnia in 55.7%, and restless legs syndrome in 28.4%. We observed a correlation between health-related quality of life with the PSQI and the Epworth sleepiness scale. Conclusion: Patients with PD have a high prevalence of sleep disorders. The quality of sleep and excessive daytime sleepiness significantly affect the quality of life in these individuals.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life

et al. 2017

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“…Restless legs syndrome (RLS) is a neurological disorder characterised by an uncontrollable urge to move the legs usually accompanied by unpleasant sensations in the legs, beginning or worsening during periods of rest, and partly relieved by movement (Hogl & Stefani, ). The prevalence of RLS in the general population is estimated to be about 10%, with a circadian pattern of onset and symptoms beginning or worsening in the evening or at night‐time (Ryan & Slevin, ; Smith & Tolson, ).…”

Section: Resultsmentioning

confidence: 99%

An overview of sleep and circadian dysfunction in Parkinson's disease

Mantovani

Smith

Gordon

et al. 2018

Journal of Sleep Research

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Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies. The scope of this narrative review is to summarise the current knowledge around both sleep and circadian alterations in Parkinson's disease. We provide an overview on the frequency of excessive daytime sleepiness, insomnia, restless legs, obstructive apnea and nocturia in Parkinson's disease, as well as addressing sleep structure, rapid eye movement sleep behaviour disorder and circadian features in Parkinson's disease. Sleep and circadian disorders have been linked to pathological conditions that are often co-morbid in Parkinson's disease, including cognitive decline, memory impairment and neurodegeneration. Therefore, targeting sleep and circadian alterations could be one of the earliest and most promising opportunities to slow disease progression. We hope that this review will contribute to advance the discussion and inform new research efforts to progress our knowledge in this field.

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“…Worse PLMS severity has been reported in patients with Parkinson's disease, multiple system atrophy, and multiple sclerosis [10][11][12], which implicates the close relationship among PLMS and structural brain diseases despite the variety in pathophysiology. CVD, the most common structural brain disease, can cause damage to any cerebral, midbrain and brainstem area, which may then contribute to worsening the severity of PLMS as with other structural brain diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Parkinson's disease, multiple system atrophy, and multiple sclerosis have been associated with a worse severity of PLMS [10][11][12], which suggests the close association between PLMS and structural brain diseases. However, there is still lack of direct evidence from large-scale studies or conclusive evidence on the association between CVA, the most common structural brain disease, and severity of PLMS.…”

Section: Introductionmentioning

confidence: 99%

Cerebrovascular Accident Risk in a Population with Periodic Limb Movements of Sleep: A Preliminary Meta-Analysis

Lin

Zeng

Chen³

et al. 2018

Cerebrovasc Dis

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Background and Purpose: Periodic limb movements of sleep (PLMS) are usually comorbid with hypertension, tachycardia, and coronary arterial diseases, which are also risk factors for cerebrovascular accidents (CVA). However, evidence about the relationship between CVA and PLMS is still weak. The aim of this study was to investigate (1) the prevalence of CVA in patients with PLMS, and (2) the severity of PLMS in patients with or without CVA through a meta-analysis. Methods: The electronic databases of PubMed, Embase, ScienceDirect, ClinicalKey, Cochrane Library, ProQuest, Web of Science, and ClinicalTrials.gov were searched. The inclusion criteria were (1) articles investigating comorbidity between PLMS and CVA, and (2) clinical trials in humans. Results: This meta-analysis included (1) 9,823 patients with PLMS and 9,416 controls from 5 studies to analyze the prevalence of CVA in PLMS, and (2) 158 patients with PLMS with CVA and 88 PLMS controls without CVA from 3 studies to analyze the severity of PLMS with and without CVA. The results showed (1) significantly higher comorbidity rates of CVA in the patients with PLMS than in the controls without PLMS (OR 1.267, p = 0.019), and (2) higher PLM index in the patients with CVA than in the controls (Hedges’ g = 0.860, p = 0.001; means difference: 4.435, p = 0.016). Conclusions: The results revealed (1) a worse severity of PLMS in the patients with CVA, and (2) increased prevalence of CVA in the patients with PLMS. Based on our results, the patients had a higher prevalence of CVA within 8 years of a diagnosis of PLMS compared to those without PLMS by about 1.3-fold. Whether (1) patients with PLMS receiving treatment have a similar incidence of stroke to those without PLMS, and (2) secondary stroke prevention can lower the severity of PLMS or whether those with severe PLMS have a higher risk of stroke is still inconclusive. Future studies investigating the prevalence of CVA in patients with PLMS should use a follow-up period of over 8 years.

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Restless legs syndrome and periodic leg movements in patients with movement disorders: Specific considerations

Cited by 57 publications

References 189 publications

High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life

High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life

An overview of sleep and circadian dysfunction in Parkinson's disease

Cerebrovascular Accident Risk in a Population with Periodic Limb Movements of Sleep: A Preliminary Meta-Analysis

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