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Research Article| Volume 357, ISSUE 1-2, P109-114, October 15, 2015

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Clinical characteristics of leg restlessness in Parkinson's disease compared with idiopathic Restless Legs Syndrome

  • Author Footnotes
    1 These authors contributed equally to this work.
    Xiao-Ying Zhu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Ye Liu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
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  • Xiao-Jin Zhang
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
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  • Wen-Hao Yang
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
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  • Ya Feng
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
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  • William G. Ondo
    Affiliations
    Department of Neurology, University of Texas Health Science Center Houston, Houston, TX, USA
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  • Eng-King Tan
    Affiliations
    Department of Neurology, Singapore General Hospital, National Neuroscience Institute, Outram Road, Singapore
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  • Yun-Cheng Wu
    Correspondence
    Corresponding author at: Department of Neurology, Shanghai General Hospital (former Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China.
    Affiliations
    Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • RLS was more asymmetrical and related to dominant Parkinsonism in PD/RLS patients.
      • PD/RLS+ patients had more severe Parkinsonism compared with PD/RLS- patients.
      • Less dopaminergic medication was used in PD/RLS+ than PD/RLS- patients when RLS onset.
      • Opposite seasonal pattern was observed in PD/RLS compared with iRLS.
      • PD/LMR had less severe symptoms of leg discomfort and Parkinsonism compared to PD/RLS.

      Abstract

      Objective

      There is limited data on motor restlessness in Parkinson's disease (PD). Here we evaluate for clinical differences between cohorts of idiopathic Restless Legs Syndrome (iRLS), PD patients with leg restlessness, and PD with RLS.

      Methods

      We examined 276 consecutive PD patients for leg restlessness symptoms, we compared clinical features of PD patients with RLS, PD patients with leg restlessness but not meeting RLS criteria, PD patient without RLS and iRLS.

      Results

      A total of 262 PD patients who satisfied the inclusion criteria were analyzed. After excluding 23 possible secondary RLS or mimics, 28 were diagnosed with RLS and 18 with leg motor restlessness (LMR). Compared with iRLS patients, PD patients with RLS or LMR had older age of RLS/LMR onset, shorter duration of leg restlessness, less positive family history, different seasonal trends and more unilaterality of leg restlessness symptom (P < 0.01) which were often in accordance with dominant Parkinsonism side and related with Parkinsonism severity. PD patients with RLS/LMR had lower daily dosage (P < 0.01) and shorter duration (P < 0.05) of dopaminergic medication when RLS/LMR symptom onset than PD without leg restlessness. PD with LMR had less severe Parkinsonism (P < 0.05) and leg restlessness (P < 0.01) symptoms than PD with RLS.

      Conclusion

      Clinical characteristics of PD patients with RLS and LMR were different from iRLS, differentiating these various subtypes can facilitate optimal treatment.

      Abbreviations:

      IRLSRS (International Restless Legs Syndrome rating scale), IRLSSG (International Restless Legs Syndrome Study Group), LED (Levodopa equivalent dosage), LMR (leg motor restlessness), PD (Parkinson's disease), PD/LMR (PD patients with LMR), PD/RLS (PD patients with RLS), RLS (Restless Legs Syndrome), UPDRS III (Unified Parkinson's Disease Rating Scale motor scale)

      Keywords

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