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Exploring the Relationship Between Parkinson Disease and Restless Legs Syndrome
William G. Ondo, MD;
Kevin Dat Vuong, MA;
Joseph Jankovic, MD
Arch Neurol. 2002;59:421-424.
Background Restless legs syndrome (RLS) and Parkinson disease (PD) are common neurological
conditions that respond to dopaminergic therapy. To our knowledge, the relationship
between the two has not been thoroughly explored.
Methods We consecutively queried 303 patients with PD seen in our clinic for
the presence of RLS symptoms, and evaluated their condition with the Epworth
Sleepiness Scale and other demographic and sleep measures. We then looked
for predictors of RLS in these patients with PD. We also compared a larger
group of patients with PD/RLS with a group of patients with RLS alone.
Results Of 303 patients with PD, 63 (20.8%) had symptoms of RLS. Neither PD
patient demographics nor PD treatments could reliably predict the development
of RLS symptoms; however, lower serum ferritin levels were associated with
RLS symptoms in our patients with PD (P = .01). In
54 (68%) of the 79 total patients with PD/RLS (including additional patients
with PD/RLS seen in the clinic) with reliable age-at-onset data, the PD symptoms
preceded the RLS symptoms ( 2 test, P<.001).
Compared with patients with idiopathic RLS (N = 146), patients with PD/RLS
(N = 109) were older at RLS onset (P<.001), were
less likely to have a family history of RLS (P<.001),
and had lower serum ferritin levels (P = .01).
Conclusions Symptoms of RLS are common in patients with PD; however, except in patients
with a family history of RLS, they seem to reflect a secondary phenomenon,
perhaps in relation with lower ferritin levels. There is no evidence that
RLS symptoms early in life predispose to the subsequent development of PD.
From the Department of Neurology, Baylor College of Medicine, Houston,
Tex.
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