Restless legs syndrome and multiple sclerosis: a Brazilian multicenter study and meta-analysis of the literature

Abstract

Objective: The increased prevalence of restless legs syndrome (RLS) in multiple sclerosis (MS) has recently been the subject of a few papers. The present study investigated the prevalence of RLS symptoms in MS patients and in controls in four Brazilian cities. Additionally, a systematic review and meta-analysis of the literature was carried out on the subject of RLS-MS. Method: MS patients and controls were investigated regarding the presence of the four typical symptoms of RLS. A questionnaire assessing RLS severity was also used for patients and controls presenting the four RLS symptoms criteria. The systematic review and meta-analysis on the subject were carried out according to the strict international criteria. Results: In the present report, the RLS-MS association was confirmed as being more than fortuitous in Brazilian MS patients, in a multicenter casecontrol study. MS patients also presented RLS symptoms of greater severity than did the control population. A systematic review and meta-analysis of the literature showed that MS patients had a fourfold higher chance of presenting RLS than did the controls. Conclusion: Although underlying mechanisms to explain the association RLS-MS are still a matter of discussion, there is a clear association of these two neurological conditions. Key words: multiple sclerosis, restless legs syndrome, meta-analysis.Síndrome das pernas inquietas e esclerose múltipla: um estudo brasileiro multicên trico e metanálise da literatura RESUMO Objetivo: A maior prevalência de síndrome das pernas inquietas (SPI) em esclerose múltipla (EM) foi recentemente assunto de algumas publicações. O presente trabalho investigou a prevalência de sintomas de SPI em pacientes com EM e em controles em quatro cidades brasileiras. Além disto, uma revisão sistemática da literatura e metanálise dos dados foi feita considerando o tema SPI-EM. Método: Pacientes com EM e controles foram investigados com relação aos quarto sintomas típicos de SPI. Um questionário avaliando a intensidade da SPI também foi utilizado para pacientes e controles que apresentassem os quatro sintomas para critério diagnóstico de SPI. A revisão sistemática e meta-análise do tema foram realizadas de acordo com os rígidos critérios internacionais. Resultados: No presente estudo, a associação de SPI-EM foi confirmada como sendo mais que coincidência nos pacientes brasileiros com EM, através do estudo caso-controle multicêntrico. Os pacientes com EM também apresentaram maior gravidade dos sintomas de SPI que os controles. A revisão sistemática e metanálise da literatura mostraram que os pacientes com EM tiveram quatro vezes mais chance de apresentar SPI do que controles. Conclusão: Embora os mecanismos envolvidos na associação SPI-EM ainda sejam motivo de discussão, existe uma clara associação entre estas duas condições neurológicas. Palavras-chave: esclerose múltipla, síndrome das pernas inquietas, metanálise. Correspondence Yára Dadalti Fragoso

Restless leg syndrome and multiple sclerosis: a case-control study in China

“…The prevalence of RLS in patients with MS (24.6 %) was much higher than in healthy controls (8.0 %), which indicates the risk of developing RLS to be almost 3.8 times higher in patients with MS. This finding was consistent with most previous studies [15][16][17][18][19][20], with only one exception [21]. Nonetheless, the reasons behind this high RLS prevalence in patients with MS are still unclear.…”

“…However, these have produced inconsistent results. For instance, some studies have found a higher frequency of RLS in patients with MS compared to the normal population [15][16][17][18][19][20], while others have reported there to be a very similar frequency of RLS in patients with MS and controls [21]. Thus, MS has not yet been regarded as a secondary cause of RLS.…”

Multiple sclerosis and restless legs syndrome: a systematic review and meta‐analysis

“…Available studies suggest that RLS prevalence amongst patients with MS is higher compared with people without MS translating into an increased risk for RLS amongst patients with MS [6][7][8][9][10][11][12][13][14][15]. However, one study did not find a statistically significant association between MS and RLS [16].…”

Restless legs syndrome in multiple sclerosis

“…Manconi et al showed that RLS prevalence was higher in PPMS than it was in other types of MS (19). Farogaso et al reported that 5 patients presented with SPMS, while 75 patients presented with RRMS (24). There was a significant relationship between the type of MS and RLS, according to Aydar et al (25).…”

“…RLS symptoms appear usually after the onset of MS (18)(19)(20)23,26,27). There is no relationship between MS subtypes and the presence of RLS (18,20,(22)(23)(24)(25)31). There are only three studies that investigated the relationship between functional system involvement and the presence of RLS in MS patients (19,23,25).…”