Restless legs syndrome in Parkinson's disease and increased cardiovascular risk

Abstract

Restless legs syndrome (RLS) is a disorder commonly found in patients with Parkinson's disease, with descriptions for both conditions impairing dopaminergic transmission in central nervous system. Previous studies in varied populations indicate an association between the presence of RLS and increased cardiovascular risk and, so far, there are no consistent studies of this association in Parkinson's disease. Objective: To analyze the influence of RLS on cardiovascular risk in patients with Parkinson's disease. Methods: We reviewed the medical records of 202 patients diagnosed with Parkinson's disease and verified the presence of RLS, cardiovascular comorbidities, blood pressure measurements, lipid profiles and Framingham Risk Scores. Results: Statistically significant higher values of total cholesterol were found for the RLS group (mean 216.6 mg/dL), as well as for LDL cholesterol (mean 145 mg/dL). No statistical difference was found among the other factors. Conclusion: Patients with Parkinson's disease and RLS have a higher prevalence of dyslipidemia than patients without RLS, suggesting a correlation between restless legs and hyperlipidemia. It is questioned whether the dopaminergic substrate is the main factor in the genesis of the syndrome, as even with the use of dopaminergic agonists by both groups, it was possible to observe differences between groups. The hypothesis of the real interference of the syndrome treatment as a protective factor for cardiovascular risk was generated.

Serum lipids and the pathogenesis of Parkinson's disease: A systematic review and meta‐analysis

“…Previous studies 37,38 have shown that more and more PD patients are complicated by hypertension, diabetes, hyperhomocysteine, dyslipidaemia, smoking and other risk factors for cerebrovascular diseases, suggesting that cognitive impairment in PD patients may be related with those risk factors. Cramer et al 39 conducted a 5‐year follow‐up study of 1674 non‐PD participants, and have found that statin lipid‐lowering drugs can reduce the incidence of cognitive dysfunction by about 50%.…”

Restless Leg Syndrome and Impulse-Control Disorders in Parkinson’s Disease: Observational study

“…The presence of a circadian profile of dopamine levels, in addition to dopaminomimetic drugs, may contribute to the coexistence of RLS and nocturnal compulsive behaviors in PD Figure1. ICD-RBs type and frequency patients (19,20). Lastly, in later stages of PD, a dopamine deficiency may occur in the nigro-striatal pathway, causing hypersensitivity of D1 and D2 receptors primarily located in the dorsal striatum, and dopaminergic medications may lead to desensitization of dopamine receptors (21).…”

Reduced regional activity and functional connectivity within sensorimotor network in Parkinson’s patients with restless legs syndrome

“…Impairment in dopaminergic transmission, common in the etiology of PD and RLS, may explain why the prevalence of RLS in patients with PD is high. 21 Dysfunction of dopaminergic signaling can directly change the brain network. Hence, we did fMRI analysis to investigate the altered patterns of brain activity and functional connections in PD patients with and without RLS by combining both ReHo and seed-based FC analyses.…”