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Abstract
Objective This review focuses on the possible association between restless legs syndrome (RLS) and movement disorders, including Parkinson disease (PD), other parkinsonian syndromes, essential tremor, choreic and dystonic syndromes, Tourette syndrome, and heredodegenerative ataxias.
Methods Review of PubMed from 1966 to September 2018 and identification of references of interest for the topic. A meta-analysis of eligible studies on the frequency of RLS in patients with PD and controls using Meta-DiSc1.1.1 software and using the PRISMA guidelines was performed.
Results and conclusions Although there are substantial clinical, neuroimaging, neuropathologic, and genetic differences between RLS and PD, many reports describe a higher than expected prevalence of RLS in patients with PD, when compared with the general population or with matched control groups; several studies have also suggested that RLS could be an early clinical feature of PD. RLS symptoms are frequent in multiple system atrophy, essential tremor, Tourette syndrome, Friedreich ataxia, and spinocerebellar ataxia type 3 as well. Finally, possible genetic links between PD and RLS (the presence of allele 2 of the complex microsatellite repeat Rep1 within the α-synuclein gene promoter) and between Tourette syndrome and RLS (several variants in the BTBD9 gene) have been reported in 2 case–control association studies, although these data, based on preliminary data with small sample sizes, need to be replicated in further studies.
Glossary
- CI=
- confidence interval;
- ET=
- essential tremor;
- FRDA=
- Friedreich ataxia;
- HD=
- Huntington disease;
- HR=
- hazard ratio;
- IRLSSG=
- International Restless Legs Syndrome Study Group;
- LMR=
- leg motor restlessness not fulfilling restless legs syndrome criteria;
- MJD=
- Machado-Joseph disease;
- MSA=
- multiple system atrophy;
- OR=
- odds ratio;
- PD=
- Parkinson disease;
- PDNRLS=
- Parkinson disease without restless legs syndrome;
- PDRLS=
- Parkinson disease with restless legs syndrome;
- PLM=
- periodic limb movements;
- PSP=
- progressive supranuclear palsy;
- RLS=
- restless legs syndrome;
- SCA3=
- spinocerebellar ataxia type 3;
- SNP=
- single-nucleotide polymorphisms;
- STN=
- subthalamic nucleus;
- TS=
- Tourette syndrome;
- WED=
- Willis-Ekbom disease
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
All authors contributed equally to the manuscript, with the exception of statistical analysis, which was performed by J.A.G. Agúndez.
- Received September 27, 2018.
- Accepted in final form February 13, 2019.
- © 2019 American Academy of Neurology
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