Restless Legs Syndrome in Parkinson's Disease Patients: Clinical Features Including Motor and Nonmotor Symptoms

Abstract

Background and Purpose We investigated the frequency and clinical features of restless legs syndrome (RLS) in patients with Parkinson's disease (PD). Methods This study included 74 PD patients. RLS was diagnosed in face-to-face assessments of all of the subjects based on diagnostic criteria of the International Restless Legs Syndrome Study Group revised in 2003. We analyzed the clinical features of PD patients with and without RLS and compared the data to idiopathic RLS. Results The frequency of RLS in the cohort was 21.6% ( n =16). Two (12.5%) of the patients with RLS were not treated with dopaminergic drugs, while 14 (24.1%) of the 58 patients without RLS received treatment with dopaminergic drugs. Anxiety, depression, and quality of life (QoL) were significantly worst in patients with RLS. PD patients with RLS had significantly worse sleep quality ( p =0.003) and worse scores on the cardiovascular subscale of the Scales for Outcomes in Parkinson's Disease for Autonomic Symptoms ( p =0.031) compared to those without RLS. In the group of PD patients with RLS, RLS preceding PD onset was related to a lower Hoehn and Yahr stage. Conclusions We found that the frequency of RLS in the present patients with PD was higher than that in our previous study of a general population of RLS subjects. Compared to the PD patients without RLS, the present PD patients with RLS suffered from worse sleep quality and QoL, depression, anxiety, and autonomic disturbances, especially those with cardiovascular problems.

The relationship between restless legs syndrome and motor subtype in patients with de novo Parkinson’s disease

“…Likewise, other studies have shown no differences in parkinsonian motor symptoms between the two groups. 8,21 However, one study showed a higher HY stage with more severe limb parkinsonism and rest tremor in PD patients with RLS than in those without RLS. 5 The clinical manifestations of PD are heterogeneous and its clinical subtypes have been empirically defined based on the prominent motor symptoms.…”

Relationship between sleep disorders and neuropsychiatric symptoms in Parkinson's disease: A narrative review

“…Research demonstrates that PD patients with RBD had significantly higher rates of anxiety and depression and a higher mean PDSS-2 score compared to ones without (36). Patients with RLS show more scores of depression and anxiety, lower sleep quality, and more autonomic dysfunctions (37).…”

Circadian and Sleep Dysfunctions in Neurodegenerative Disorders—An Update

“…Restless Legs Syndrome (RLS) is another primary sleep disorder frequently associated with PD. In contrast to RBD, whether RLS is also a risk factor for subsequent development of PD is still a subject of debate ( Alonso-Navarro et al, 2019 ; You et al, 2019 ). True prevalence of RLS in PD is not well established as many mimickers of RLS frequently affect PD patients, such as akathisia, rigidity, and leg cramps ( You et al, 2019 ).…”

“…In contrast to RBD, whether RLS is also a risk factor for subsequent development of PD is still a subject of debate ( Alonso-Navarro et al, 2019 ; You et al, 2019 ). True prevalence of RLS in PD is not well established as many mimickers of RLS frequently affect PD patients, such as akathisia, rigidity, and leg cramps ( You et al, 2019 ). While both RLS and PD respond favorably to dopaminergic medications and are worsened by the administration of dopamine blocking medications, there are sharp differences from a neuropathological standpoint.…”