Pathophysiological concepts of restless legs syndrome

Paulus, Walter; Dowling, Pascal; Rijsman, Roselyne M.; Stiasny‐Kolster, Karin; Trenkwalder, Claudia; Weerd, Al de

doi:10.1002/mds.21533

Cited by 98 publications

(86 citation statements)

References 62 publications

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“…There are several studies that show clear symptom relief of RLS; otherwise, treatment with levodopa or dopamine agonists is very successful [20]. …”

Section: Discussionmentioning

confidence: 99%

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Restless Legs Syndrome Is Common among Female Patients with Fibromyalgia

Stehlik¹,

Arvidsson²,

Ulfberg³

2008

Eur Neurol

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Background: The prevalence of restless legs syndrome (RLS) among the general population is 2–15%, and with fibromyalgia syndrome (FMS) 2%. Both RLS and FMS are more common among women. The aim of our study was to evaluate the prevalence of RLS in a group of female patients diagnosed with FMS and to compare the occurrence of symptoms of daytime sleepiness and experienced sleep disorders between fibromyalgia patients with or without RLS. Method: Three hundred and thirty-two female patients, 20–60 years old, diagnosed with FMS at Skönviks Rehab between 2002 and 2006, answered a questionnaire mailed to their home address. The questionnaire consisted of the international RLS study group criteria as well as of questions concerning symptoms of insomnia and daytime sleepiness measured according to the Epworth Sleepiness Scale. Results: Nearly 64% of the women were also suffering from RLS. More patients suffering from both RLS and FMS were affected by problems of initiating and maintaining sleep than those suffering from FMS only. More patients suffering from both RLS and FMS did not feel refreshed on awakening compared with those suffering from FMS without RLS. The patients with concomitant RLS and FMS were more often hypersomnolent than those suffering from FMS only. Conclusion: This study shows that 64% of a group of female patients diagnosed with fibromyalgia also concurrently suffered from RLS. Compared with patients who suffer from FMS only, patients with both FMS and RLS more often experience sleep disturbances and pronounced daytime sleepiness.

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“…There are several studies that show clear symptom relief of RLS; otherwise, treatment with levodopa or dopamine agonists is very successful [20]. …”

Section: Discussionmentioning

confidence: 99%

“…The subjects were also asked to fill out the Epworth Sleepiness Scale, a simple tool for evaluating excessive daytime sleepiness that has been validated and is used worldwide [20]. This scale consists of 8 questions concerning situations associated with daily activities.…”

Section: Methodsmentioning

confidence: 99%

Restless Legs Syndrome Is Common among Female Patients with Fibromyalgia

Stehlik¹,

Arvidsson²,

Ulfberg³

2008

Eur Neurol

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“…915 The pathophysiologic basis of RLS is not known, but dysfunction of dopamine neurons in the striatum, spinal cord, and A1 neurons of the hypothalamus have been implicated as they modulate spinal excitability and sensory processing of leg afferents, and because dopaminergic therapies are effective in the treatment of this disorder. 916 This of course has led to speculation on a possible relationship between RLS and PD, 917 although as indicated above this has not as yet been conclusively established.…”

mentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

747

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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“…An increased prevalence of restless legs syndrome (RLS) among FM patients has also been described 6 . While the exact etiology of RLS remains poorly understood, there is mounting evidence from both neuroimaging studies 7 and from patient response to pharmacological intervention 8 to indicate a role for central dopamine in the pathogenesis of RLS.…”

mentioning

confidence: 99%