Comorbidity of Migraine and Restless Legs Syndrome—A Case-Control Study

Abstract

In order to evaluate a possible association between migraine and restless legs syndrome (RLS), we performed a case-control study on the comorbidity of RLS and migraine. Patients with migraine (n = 411) and 411 sex- and age-matched control subjects were included. Migraine was diagnosed according to International Headache Society criteria, RLS according to the criteria of the International Restless Legs Syndrome Study Group. Furthermore, all patients had to fill out a self-assessment test performance on depression [Beck's Depression Inventory (BDI)]. RLS frequency was significantly higher in migraine patients than in control subjects (17.3% vs. 5.6%, P < 0.001; odds ratio 3.5, confidence interval 2.2, 5.8). In our sample, there was no significant association between migraine and depression as defined by the BDI score (9.6% in migraine vs. 4.0% in control subjects, P = 0.190). Depression was, however, not significantly more frequent in migraine patients with RLS (13.6%) than in migraine patients without RLS (8.7%). In addition, migraine patients with RLS had a significantly higher BDI score. RLS features did not differ significantly between migraine patients with RLS and control subjects with RLS. There is an association between RLS and migraine and, in addition, a co-association with depression. The underlying mechanism, however, remains undetermined and might be related to a dysfunction of dopaminergic metabolism in migraine.

Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine

“…We found a significant association between migraine and RLS in a Brazilian population, as reported in previous studies [17][18][19][20][21] . However, most studies were case series or studies of the case-control type, a fact that weakened these results.…”

“…Regarding the characteristics of migraine, in our study no association was seen between the presence of aura, premonitory symptoms, frequency and severity of pain and RLS, as suggested by previous studies 17,20,21 . Similarly, no differences were observed between clinical features of RLS and migraine status.…”

“…We found no association between demographic variables (gender, age, marital status and years of education) and headache or RLS status, as reported by others [17][18][19][20][21][22][23][24][25] .…”

“…The comorbidity between migraine and RLS was suggested before and shared dopaminergic dysfunctions may explain the association [17][18][19][20][21] . We do not know if comorbidities, medication used or depressive symptoms can explain the relation between migraine and RLS.…”

“…We do not know if comorbidities, medication used or depressive symptoms can explain the relation between migraine and RLS. Furthermore, only partial assessment of hidden comorbidities, such as diabetes, neuropathies or depression (often treated with medications that block dopamine) has been conducted [17][18][19][20][21][22] . Nonetheless, since migraineurs are often treated with dopaminergic antagonists, which, in turn, increase the risk of RLS, it is important to consider treatment when assessing the comorbidity, and this is yet to be done.…”