Restless legs syndrome, leg motor restlessness and their variants in patients with Parkinson's disease and related disorders

Matsubara, Takeo; Suzuki, Keisuke; Watanabe, Yuji; Sakuramoto, Hirotaka; Matsubara, Masanori; Hirata, Koichi

doi:10.1016/j.jns.2018.08.007

Cited by 13 publications

(6 citation statements)

References 46 publications

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“…In one study, LMR was found to be more prevalent in de novo patients with PD than in healthy controls [6]. Based on past research, the prevalence of LMR among PD patients ranges from 15.2 to 40.5% [25][26][27][28], while in agematched controls, the LMR prevalence ranged from 4.5 to 16.2% [9,[26][27][28][29]. Current research suggests that various types of restless and abnormal sensations, such as those occurring in RLS and LMR, are largely the result of endogenous brain dopamine deficiency [9].…”

Section: Restless Legs Syndrome/willis-ekbom Disease and Leg Motor Restlessnessmentioning

confidence: 99%

“…Based on past research, the prevalence of LMR among PD patients ranges from 15.2 to 40.5% [25][26][27][28], while in agematched controls, the LMR prevalence ranged from 4.5 to 16.2% [9,[26][27][28][29]. Current research suggests that various types of restless and abnormal sensations, such as those occurring in RLS and LMR, are largely the result of endogenous brain dopamine deficiency [9]. In a study of PD patients, although neuropathy was not associated with RLS or LMR, LMR (but not RLS) was associated with an earlier onset of PD [30].…”

Section: Restless Legs Syndrome/willis-ekbom Disease and Leg Motor Restlessnessmentioning

confidence: 99%

“…Additional research showed that PD patients with restlessness, including RLS and LMR, scored higher on the Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), the Parkinson's Disease Sleep Scale-2 (PDSS-2), and Beck Depression Inventory-II (BDI-II) than did those without restlessness, indicating that autonomic dysfunction, sleep disorders, and depressive symptoms were common in patients complaining of restlessness [9]. There is a well-known association between RLS and depression in all age groups [8][9][10]. Furthermore, it has been proposed that sleep disturbance might mediate the association between RLS and depression [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Association between leg motor restlessness and depression among Chinese males living at high-altitude: the mediating role of insomnia

et al. 2020

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Objective Previous research has documented an association between insomnia and depression among patients with restless legs syndrome (RLS)/Willis-Ekbom disease. Given that leg motor restlessness (LMR) is closely related to RLS, the purpose of this study was to investigate the prevalence of insomnia and depression among individuals with LMR. In addition, we examined the associations among LMR, insomnia, and depression in a sample of young Chinese men living in high-altitude areas. Methods Chinese military personnel working on the Qinghai Tibet Plateau (Lhasa, an altitude of 3600 m) were recruited in 2019 to complete a series of questionnaires. Participants having the urge to move their legs but not meeting the diagnostic criteria for RLS were classified as having LMR. Hierarchical linear regressions and mediational analyses using the SPSS PROCESS macro in SPSS were conducted to examine the associations among LMR, insomnia, and depression. Results Of 196 participants, 36 (18%) had LMR. Only 1 participant was diagnosed with RLS. The proportions of participants suffering from insomnia who had LMR and did not have LMR were 44% and 22%, respectively. For depression, the proportions were 47% and 28%, respectively. Results of the hierarchical linear regressions showed that both LMR and depression were associated with increased insomnia symptoms. In addition, results from the mediational analyses indicated that the indirect effect of LMR on depression was significant and accounted for 52% of the total effect. Conclusions Participants with LMR had a higher prevalence of insomnia and depression compared with those without LMR. In addition, LMR was correlated with depression, and insomnia played a significant role in this co-occurrence.

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Section: Restless Legs Syndrome/willis-ekbom Disease and Leg Motor Restlessnessmentioning

confidence: 99%

Section: Restless Legs Syndrome/willis-ekbom Disease and Leg Motor Restlessnessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between leg motor restlessness and depression among Chinese males living at high-altitude: the mediating role of insomnia

et al. 2020

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“…RLS variants, in which restlessness and unpleasant sensations are limited to or predominantly involve regions other than the legs in patients with PD (lower back and perianal region), have been reported. [31,32] We recently conducted a cross-sectional survey on RLS/LMR and their variants in patients with PD-related disorders; the survey showed that RLS and LMR were observed in 11.5% and 7.7% of untreated patients with PD, respectively [33] . Given that any form of comorbid restlessness was associated with depressive symptoms, insomnia, and autonomic impairment in the study, [33] screening and management of RLS-related symptoms in PD patients is important.…”

Section: Discussionmentioning

confidence: 99%

Leg restlessness preceding the onset of motor symptoms of Parkinson disease

Suzuki

Fujita²,

Watanabe³

et al. 2019

Medicine

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Patients with Parkinson disease (PD) often show restless legs syndrome (RLS), leg motor restlessness (LMR) and other leg restlessness (OLR) related to sensorimotor symptoms.Here, we describe 5 patients who presented with leg restlessness as an early manifestation of PD.In case 1, the patient had leg restlessness that was not LMR or RLS and preceded the onset of motor symptoms by 1 year. In case 2, LMR preceded motor symptoms by 2 years. Case 3 had unilateral RLS symptoms on the left side of the body for 33 years. Two and a half years after the spread of RLS symptoms to the right leg with increased frequency of left-sided RLS symptoms, the patient developed PD at the age of 58 years. In cases 4 and 5, RLS symptoms preceded motor symptoms by 3 months and 1 month, respectively. All patients developed Parkinsonism within 3 years (median, 1.0 year; range 0.083–2.5 years) after initial onset or exacerbation of leg restlessness. All patients had frequent leg restlessness symptoms (6–7 days per week). In our series, the preceding leg restlessness was unilateral and confined to the dominant side of the subsequent Parkinsonism, or preceding leg restlessness was bilateral but dominant on the dominant side of the subsequent Parkinsonism.Clinicians should be aware that late-onset leg restlessness (>50 years of age) including RLS, LMR, and OLR, particularly if frequent and asymmetrical, can be an early nonmotor manifestation of PD.

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“…On the other hand, several studies support that restless leg syndrome (RLS) and PD share a common neuropathology and highlight that RLS is more frequent in patients with longer disease duration, suggesting the role of progressive dopamine depletion in its occurrence. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

Impulse-control disorders and restless leg syndrome in Parkinson's Disease: Association or coexistence

Paul

Aggarwal

Paul

et al. 2023

Ann Indian Acad Neurol

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Background: Both Impulse-control disorders and related behaviours (ICD-RB) and restless leg syndrome (RLS) are relatively common in patients with Parkinson’s disease, but little is known are they related or independent complications of dopaminergic therapy. The aim of this study was to determine the correlation between ICD-RBs and RLS and also, to determine the associated significant psycho-behavioural profile of RLS patients in presence of ICD-RBs. Methods: PD who visited neurology OPD were screened for the presence of addictive behaviors, alcohol and substance abuse, ICDs including Impulse control disorders not elsewhere classified with the help of a QUIP questionnaire. RLS was evaluated by diagnostic criteria set by the International RLS study group. To evaluate the association of RLS and ICDs, cohort was divided into groups of patients who had both ICD and RLS, ICD with no RLS, RLS with no ICD and no ICD or RLS. Results: Among 122 PD patients who visited OPD, 95 eligible were included in the study. Out of these 95 patients, 51 (53.6%) had at least one ICD-RB and 18 (18.9%) had RLS. ICD-RB in decreasing order of frequency were compulsive medication (47.4%), compulsive eating (29.4%), compulsive buying (17.6%), gambling (11.7%), hypersexuality (3.9%), and others (29.8%). Among 18 patients with RLS, 12 (66.7%) were associated with at least one ICD-RB. The compulsive behaviours significantly associated with PD-RLS group were gambling (27.8%), followed by compulsive eating (44.2%). While comparing disease characteristics, PD-ICD/RLS patients had statistically significant disease duration ( p 0.007) and higher LEDD (p 0.004). Other demographic and socioeconomic features did not reveal any differences between the groups. Conclusion: 11% of PwPD can have co-occurrence of RLS and ICD-RBs. Circadian fluctuation in levels of dopamine release on the background of hyper-dopaminergic state produces waves of crest and trough, which may be possible for this behavioral profile. Long-term dopaminergic treatment or degenerative process itself may be the cause leading to emergence of both RLS and ICD-RBs in PD patients.

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Restless legs syndrome, leg motor restlessness and their variants in patients with Parkinson's disease and related disorders

Cited by 13 publications

References 46 publications

Association between leg motor restlessness and depression among Chinese males living at high-altitude: the mediating role of insomnia

Association between leg motor restlessness and depression among Chinese males living at high-altitude: the mediating role of insomnia

Leg restlessness preceding the onset of motor symptoms of Parkinson disease

Impulse-control disorders and restless leg syndrome in Parkinson's Disease: Association or coexistence

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