Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study
Authors Sanghera M, Sales S, Robinson J, Song J, Encarnacion E, Stewart M
Received 7 February 2015
Accepted for publication 12 May 2015
Published 20 October 2015 Volume 2015:5 Pages 33—38
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 5
Editor who approved publication: Dr Abdul Qayyum Rana
Manjit K Sanghera,1 Samantha G Sales,2 Jennifer L Robinson,1 Juhee Song,3 Elmyra V Encarnacion,4 R Malcolm Stewart5
1Department of Neurosurgery, Baylor-Scott and White Hospital, Temple, TX, 2Texas A & M College of Medicine, College Station, TX, 3Department of Biostatistics, Baylor-Scott and White Hospital, Temple, TX, 4Department of Neurology, Baylor-Scott and White Hospital, Temple, TX, 5Human Performance Laboratory, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
Introduction: Restless legs syndrome (RLS) is a chronic sensorimotor disorder characterized by discomfort or pain, predominantly in the legs, resulting in an urge to move during times of rest. These disturbances are often accompanied by sleep fragmentation, which can significantly increase medical comorbidities over time and can have a detrimental effect on a patient's overall quality of life. In this retrospective study, we examined the temporal relationship between the time of RLS diagnosis and the onset of non-motor symptoms (NMS) and medical comorbidities.
Patients and methods: Thirty-six RLS patients were evaluated for age at: symptom onset, time of diagnosis, time of occurrence of NMS, and medical comorbidities. We used structured interviews, validated questionnaires, and past medical records to aggregate and verify patient data. There was no clinical evidence to suggest secondary RLS in any patient at time of diagnosis.
Results: Twenty-five patients were diagnosed as having RLS alone and eleven were diagnosed with RLS and Parkinson's disease (RLS + PD). In the RLS + PD group, irrespective of which disorder presented first, we found that patients exhibited symptoms of RLS at a significantly later age than those patients with RLS alone (P<0.05). The incidence and severity of NMS were significantly higher in the RLS + PD group compared to RLS alone and controls (P<0.001). Increased risk of RLS was identified in patients exhibiting mood changes and sleep deficits, and these risk factors manifested 5 and 10 years prior, respectively, to their diagnosis.
Conclusion: Primary RLS develops earlier in those patients who only have RLS compared to those who later also develop PD. Mood and sleep impairment can be present years prior to the diagnosis of RLS. Other medical comorbidities associated with RLS included hypertension, hyperlipidemia, arthritis, chronic pain, and diabetes.
Keywords: restless legs syndrome, non-motor symptoms, medical comorbidities, risk factors for RLS
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