J Clin Neurol.  2019 Jul;15(3):321-327. 10.3988/jcn.2019.15.3.321.

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

• You S
• Jeon SM
• Do SY
• Cho YW

• KMID: 2451115
• DOI: http://doi.org/10.3988/jcn.2019.15.3.321

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.

Keyword

Parkinson disease; restless legs syndrome; prevalence; dysautonomia; sleep

MeSH Terms

Anxiety
Cohort Studies
Depression
Dopamine Agents
Humans
Parkinson Disease*
Prevalence
Primary Dysautonomias
Quality of Life
Restless Legs Syndrome*
Weights and Measures
Dopamine Agents

Figure

• 

  Fig. 1 Correlation analysis between RLS severity and PD nonmotor symptom severity. RLS severity was positively correlated with ISI (A) and negatively correlated with PDSS score (B). The SCOPA-AUT total score (C) and urinary subscore (D) were positively correlated with RLS severity. IRLS: international restless legs syndrome, ISI: Insomnia Severity Index, PDSS: Parkinson's Disease Sleep Scale, RLS: restless legs syndrome, SCOPA-AUT: Scales for Outcomes in Parkinson's Disease for Autonomic Symptoms.

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