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A Four-Year Longitudinal Study on Restless Legs Syndrome in Parkinson Disease.
Sleep. 2016 Feb 01; 39(2):405-12.S

Abstract

STUDY OBJECTIVES

Restless legs syndrome (RLS) prevalence estimates range from 0% to 52% in Parkinson disease (PD), but the causal relationship between the two disorders is still debated. The present study aims to evaluate RLS prevalence in de novo PD subjects, its incidence during the first 4 years from diagnosis, and possible relationships with clinical, laboratory, and neuroradiological data.

METHODS

One hundred nine newly diagnosed, drug-naïve PD subjects were evaluated at the time of PD diagnosis, and after 2- and 4-years. RLS diagnosis was performed with the RLS Diagnostic Index at each visit. Motor features, additional non-motor symptoms (NMS), and concomitant dopaminergic and nondopaminergic treatments were also gathered. Moreover, at baseline, 65 subjects were randomly selected to undergo a FP-CIT SPECT to study dopamine transporter availability.

RESULTS

RLS prevalence rose from 4.6% at baseline evaluation to 6.5% after 2 years and to 16.3% after 4 years (P = 0.007). A multinomial logistic stepwise regression model selected NMS Questionnaire items more likely to be associated with RLS at diagnosis (insomnia, OR = 15.555; P = 0.040) and with occurrence of RLS during follow-up (dizziness, OR = 1.153; P = 0.022; and daytime sleepiness; OR = 9.557; P = 0.001), as compared to patients without RLS. Older age was more likely associated to increased RLS occurrence during follow-up in a random effect logistic regression model (OR = 1.187; P = 0.036). A multinomial logistic stepwise model found increased dopaminergic transporter availability of affected caudate and putamen to be more likely associated with RLS presence at diagnosis (n = 5; OR = 75.711; P = 0.077), and RLS occurrence during follow-up (n = 16; OR = 12.004; P = 0.059), respectively, as compared to patients without RLS (n = 88).

CONCLUSIONS

RLS is present since PD diagnosis, and increases in prevalence during the course of PD. PD subjects with RLS have higher age at PD onset, more preserved dopaminergic pathways, and worse sleep and cardiovascular disturbances.

Authors+Show Affiliations

Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy.Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK. Department of Neurological and Movement Sciences, University of Verona, Policlinico Borgo Roma, Verona, Italy.Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy. Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.Department of Psychology, Neuropsychology Laboratory, Second University of Naples, Caserta, Italy. IDC Hermitage-Capodimonte, Naples, Italy.Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy.Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy.IDC Hermitage-Capodimonte, Naples, Italy.IDC Hermitage-Capodimonte, Naples, Italy.Department of Primary Care and Public Health, Imperial College, London, UK. Department of Public Health, Federico II University, Naples, Italy.Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy.Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy.Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy.IDC Hermitage-Capodimonte, Naples, Italy. Department of Motor Sciences, University Parthenope, Naples, Italy.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26564123

Citation

Moccia, Marcello, et al. "A Four-Year Longitudinal Study On Restless Legs Syndrome in Parkinson Disease." Sleep, vol. 39, no. 2, 2016, pp. 405-12.
Moccia M, Erro R, Picillo M, et al. A Four-Year Longitudinal Study on Restless Legs Syndrome in Parkinson Disease. Sleep. 2016;39(2):405-12.
Moccia, M., Erro, R., Picillo, M., Santangelo, G., Spina, E., Allocca, R., Longo, K., Amboni, M., Palladino, R., Assante, R., Pappatà, S., Pellecchia, M. T., Barone, P., & Vitale, C. (2016). A Four-Year Longitudinal Study on Restless Legs Syndrome in Parkinson Disease. Sleep, 39(2), 405-12. https://doi.org/10.5665/sleep.5452
Moccia M, et al. A Four-Year Longitudinal Study On Restless Legs Syndrome in Parkinson Disease. Sleep. 2016 Feb 1;39(2):405-12. PubMed PMID: 26564123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Four-Year Longitudinal Study on Restless Legs Syndrome in Parkinson Disease. AU - Moccia,Marcello, AU - Erro,Roberto, AU - Picillo,Marina, AU - Santangelo,Gabriella, AU - Spina,Emanuele, AU - Allocca,Roberto, AU - Longo,Katia, AU - Amboni,Marianna, AU - Palladino,Raffaele, AU - Assante,Roberta, AU - Pappatà,Sabina, AU - Pellecchia,Maria Teresa, AU - Barone,Paolo, AU - Vitale,Carmine, Y1 - 2016/02/01/ PY - 2015/03/23/received PY - 2015/08/14/accepted PY - 2015/11/14/entrez PY - 2015/11/14/pubmed PY - 2016/11/10/medline KW - DAT KW - Parkinson KW - RLS KW - SPECT KW - progression KW - restless KW - sleep SP - 405 EP - 12 JF - Sleep JO - Sleep VL - 39 IS - 2 N2 - STUDY OBJECTIVES: Restless legs syndrome (RLS) prevalence estimates range from 0% to 52% in Parkinson disease (PD), but the causal relationship between the two disorders is still debated. The present study aims to evaluate RLS prevalence in de novo PD subjects, its incidence during the first 4 years from diagnosis, and possible relationships with clinical, laboratory, and neuroradiological data. METHODS: One hundred nine newly diagnosed, drug-naïve PD subjects were evaluated at the time of PD diagnosis, and after 2- and 4-years. RLS diagnosis was performed with the RLS Diagnostic Index at each visit. Motor features, additional non-motor symptoms (NMS), and concomitant dopaminergic and nondopaminergic treatments were also gathered. Moreover, at baseline, 65 subjects were randomly selected to undergo a FP-CIT SPECT to study dopamine transporter availability. RESULTS: RLS prevalence rose from 4.6% at baseline evaluation to 6.5% after 2 years and to 16.3% after 4 years (P = 0.007). A multinomial logistic stepwise regression model selected NMS Questionnaire items more likely to be associated with RLS at diagnosis (insomnia, OR = 15.555; P = 0.040) and with occurrence of RLS during follow-up (dizziness, OR = 1.153; P = 0.022; and daytime sleepiness; OR = 9.557; P = 0.001), as compared to patients without RLS. Older age was more likely associated to increased RLS occurrence during follow-up in a random effect logistic regression model (OR = 1.187; P = 0.036). A multinomial logistic stepwise model found increased dopaminergic transporter availability of affected caudate and putamen to be more likely associated with RLS presence at diagnosis (n = 5; OR = 75.711; P = 0.077), and RLS occurrence during follow-up (n = 16; OR = 12.004; P = 0.059), respectively, as compared to patients without RLS (n = 88). CONCLUSIONS: RLS is present since PD diagnosis, and increases in prevalence during the course of PD. PD subjects with RLS have higher age at PD onset, more preserved dopaminergic pathways, and worse sleep and cardiovascular disturbances. SN - 1550-9109 UR - https://www.unboundmedicine.com/medline/citation/26564123/A_Four_Year_Longitudinal_Study_on_Restless_Legs_Syndrome_in_Parkinson_Disease_ L2 - https://academic.oup.com/sleep/article-lookup/doi/10.5665/sleep.5452 DB - PRIME DP - Unbound Medicine ER -