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L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children.
Sleep Med 2011; 12(5):471-7SM

Abstract

BACKGROUND

In a previous open-label study, dopaminergic agents improved Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS), as well as Attention-Deficit-Hyperactivity Disorder (ADHD) in children with both disorders. We therefore conducted a double-blind placebo-controlled trial of L-DOPA in ADHD children with and without RLS/PLMS.

METHODS

Two groups of patients (total n = 29), those with ADHD only or those with ADHD and RLS/PLMS, were randomized to L-DOPA or placebo therapy. At baseline and after therapy patients were assessed with Conners' parent and teacher rating scales; polysomnography; RLS rating scale; and neuropsychometric measures of memory, learning, attention, and vigilance.

RESULTS

L-DOPA improved RLS/PLMS symptoms in all patients with those disorders compared with placebo (p = .007). When assessed by the Conners' Scales before therapy, ADHD was more severe in children without RLS/PLMS than in children with RLS/PLMS (p = 0.006). L-DOPA had no effect on Conners' scales, sleep, or neuropsychometric tests when all patients treated with the drug were compared to those on placebo or when patients with ADHD only were compared to those with ADHD and RLS/PLMS.

CONCLUSIONS

In this first double-blind study of a dopaminergic therapy in children with RLS/PLMS, L-Dopa significantly improved RLS/PLMS but not ADHD. These results, however, should be interpreted carefully since they may have been influenced by the relatively small sample size and the baseline differences in severity of ADHD symptoms. Further work needs to be done to elucidate the relationship between dopamine, ADHD and RLS/PLMS.

Authors+Show Affiliations

UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21463967

Citation

England, Sandra J., et al. "L-Dopa Improves Restless Legs Syndrome and Periodic Limb Movements in Sleep but Not Attention-Deficit-Hyperactivity Disorder in a Double-blind Trial in Children." Sleep Medicine, vol. 12, no. 5, 2011, pp. 471-7.
England SJ, Picchietti DL, Couvadelli BV, et al. L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children. Sleep Med. 2011;12(5):471-7.
England, S. J., Picchietti, D. L., Couvadelli, B. V., Fisher, B. C., Siddiqui, F., Wagner, M. L., ... Walters, A. S. (2011). L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children. Sleep Medicine, 12(5), pp. 471-7. doi:10.1016/j.sleep.2011.01.008.
England SJ, et al. L-Dopa Improves Restless Legs Syndrome and Periodic Limb Movements in Sleep but Not Attention-Deficit-Hyperactivity Disorder in a Double-blind Trial in Children. Sleep Med. 2011;12(5):471-7. PubMed PMID: 21463967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children. AU - England,Sandra J, AU - Picchietti,Daniel L, AU - Couvadelli,Barbara Vera, AU - Fisher,Barbara C, AU - Siddiqui,Fouzia, AU - Wagner,Mary L, AU - Hening,Wayne A, AU - Lewin,Daniel, AU - Winnie,Glenna, AU - Cohen,Barry, AU - Walters,Arthur S, Y1 - 2011/04/03/ PY - 2010/05/24/received PY - 2011/01/19/revised PY - 2011/01/26/accepted PY - 2011/4/6/entrez PY - 2011/4/6/pubmed PY - 2011/9/2/medline SP - 471 EP - 7 JF - Sleep medicine JO - Sleep Med. VL - 12 IS - 5 N2 - BACKGROUND: In a previous open-label study, dopaminergic agents improved Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS), as well as Attention-Deficit-Hyperactivity Disorder (ADHD) in children with both disorders. We therefore conducted a double-blind placebo-controlled trial of L-DOPA in ADHD children with and without RLS/PLMS. METHODS: Two groups of patients (total n = 29), those with ADHD only or those with ADHD and RLS/PLMS, were randomized to L-DOPA or placebo therapy. At baseline and after therapy patients were assessed with Conners' parent and teacher rating scales; polysomnography; RLS rating scale; and neuropsychometric measures of memory, learning, attention, and vigilance. RESULTS: L-DOPA improved RLS/PLMS symptoms in all patients with those disorders compared with placebo (p = .007). When assessed by the Conners' Scales before therapy, ADHD was more severe in children without RLS/PLMS than in children with RLS/PLMS (p = 0.006). L-DOPA had no effect on Conners' scales, sleep, or neuropsychometric tests when all patients treated with the drug were compared to those on placebo or when patients with ADHD only were compared to those with ADHD and RLS/PLMS. CONCLUSIONS: In this first double-blind study of a dopaminergic therapy in children with RLS/PLMS, L-Dopa significantly improved RLS/PLMS but not ADHD. These results, however, should be interpreted carefully since they may have been influenced by the relatively small sample size and the baseline differences in severity of ADHD symptoms. Further work needs to be done to elucidate the relationship between dopamine, ADHD and RLS/PLMS. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/21463967/L_Dopa_improves_Restless_Legs_Syndrome_and_periodic_limb_movements_in_sleep_but_not_Attention_Deficit_Hyperactivity_Disorder_in_a_double_blind_trial_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(11)00086-4 DB - PRIME DP - Unbound Medicine ER -