- •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.
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.
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.
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.
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)
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Published online: July 08, 2015
Accepted: July 6, 2015
Received in revised form: July 5, 2015
Received: May 5, 2015
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.