1,720,975 research outputs found
Frontal intermittent rhythmic delta activity (FIRDA) in patients with dementia with Lewy bodies: a diagnostic tool?
No full text
A long-term prospective follow-up study of incident RLS in the course of chronic DAergic therapy in newly diagnosed untreated patients with Parkinson's disease
No full textIt is currently controversial if and in which terms Parkinson's disease (PD) and restless legs syndrome (RLS) are linked in co-morbid association. In a cohort of 106 de novo PD patients (67 male and 39 female, aged 42-83 years), 15 of them developed RLS, which was prospectively assessed at 6-month intervals from the starting of dopamine(DA)ergic therapy. The incidence rate of total RLS was 47 per 1,000 case/person per year and 37 per 1,000 case/person per year after the exclusion of possible "secondary" forms of the disorder (n = 3). These figures are higher than those reported in an incidence study conducted in German general population (Study of Health in Pomerania), in which the method of ascertainment of RLS similar to ours has been used. An incidence rate of total RLS significantly higher than that reported in the above-mentioned study was found in the age ranges 55-64 years and in the age range 45-74 years standardized to European general population 2013 (70 and 53 per 1,000 case/person per year, respectively, p < 0.01). Ten out of 12 patients (83.3 %) developed RLS within 24 months from the starting of DAergic medication (median latency 7.5 months). These findings support the view that sustained DAergic therapy could represent the critical factor inducing an increased incidence of RLS in patients with PD and that the latter disease should be regarded as the condition predisposing to the occurrence of the former and not viceversa as previously hypothesized. The mechanism underlying the increased incidence of RLS remains unclear and deserves further investigation
Absence of co-morbidity of Parkinson disease and restless legs syndrome: a case–control study in patients attending a movement disorders clinic
No full textWe have carried out a case-control survey of the prevalence of restless legs syndrome (RLS) in 118 Parkinson's disease out-patients with different stage of disease severity by using the International restless legs syndrome Study Group clinical criteria. This study failed to demonstrate a significantly augmented prevalence of either primary and secondary restless legs syndrome pooled together or primary restless legs syndrome alone among Parkinson's disease patients as compared to age and gender matched controls. The results of our survey do not confirm a significant co-morbid occurrence of the two disorders. However, an unavoidable limitation of this and all previous studies is that most of the patients examined were already treated with dopaminomimetic drugs, which could have abolished a mild unrecognized RLS anteceding the diagnosis of Parkinson's disease or possibly masked the subsequent emergence of the sensory-motor disorder following the onset of Parkinson's disease
Restless legs syndrome in diabetic neuropathy: a frequent manifestation of small fiber neuropathy
No full textAs the occurrence of restless legs syndrome (RLS) in diabetes is controversial, the aim of this study was to assess the prevalence of RLS in a cohort of patients with diabetic neuropathy and to analyze the features of the associated neuropathy. We investigated the occurrence of RLS diagnosed in accordance with the criteria of the International Restless Legs Syndrome Study Group in a cohort of patients with polyneuropathy and mononeuropathy multiplex associated with diabetes mellitus (DM), or impaired glucose tolerance (IGT), or impaired fasting glucose (IFG) in a retrospective study. RLS was present in 33/99 patients with neuropathy associated with DM/IGT/IFG (84 with distal polyneuropathy and 15 with multiple mononeuropathy). Comparing patients with or without RLS, small fiber sensory neuropathy was more common in the RLS patients (15/33 vs. 15/66), as were symptoms of burning feet (10/33 vs. 6/66). In several patients, RLS was responsive to neuropathic pain medications. The frequent occurrence of RLS in association with thermal dysesthesias may reflect the involvement of small sensory fibers in the form of hyperexcitable C fibers or A-delta fiber deafferentation. We suggest that RLS may be triggered by abnormal sensory inputs from small fibers, especially involved in neuropathy associated with DM/IGT/IFG. Our data show that RLS is a relevant feature of diabetic neuropathy, as a frequent and potentially treatable manifestation of small fiber involvement in the course of DM and IGT/IFG
Restless legs syndrome and Parkinson's disease
No full textWe were highly surprised on reading the recent article by Peralta et al., in which an augmented prevalence of restless legs syndrome (RLS) in patients with Parkinson's disease (PD) has been reported, without mentioning at all (and consequently having excluded) the well-established conditions causing secondary forms of the sensory-motor disorder, possibly occurring in the patients studied, and without including their own control population. This could have biased the results producing an overestimate of the frequency of assumed "primary" RLS in their patients, consequently corroborating the currently controversial issue of a significant comorbid association between the two disorders. Indeed, in our recently published survey on 118 PD outpatients the exclusion of secondary causes of RLS, and therefore, only considering the assumed "primary" forms of the disorder, resulted in a further reduced statistically not significant frequency of RLS in PD patients. In addition, in our study, only a limited proportion of PD patients, that is, 30 of 118 (25.4%), presented with motor fluctuations such as levodopa (L-dopa) end-of-dose deterioration, and among them only one patient, that is, 3.3%, was found suffering from assumed "primary" RLS. In contrast, the finding that in the study by Peralta et al. the majority of PD patients with RLS-like symptoms, that is 20 of 28 (71.4%), were presenting with Ldopa-related motor fluctuations or, conversely, that 28 of 75 patients, (37.3%) with motor fluctuations scored positive for RLS indicates that the occurrence of confounding conditions, that is, "mimics" of RLS, were particularly relevant in their population of PD patients. Therefore, the conclusion of the authors that their study "suggests that RLS-like symptoms are part of the sensory-motor spectrum of wearing-off in Ldopa treated PD" only confirms the well-known notion that "mimics" of RLS may confound the detection of "true" RLS in these patients, making, in our opinion, the results of their study, as well as those of some others in which the presence of motor fluctuations has not been quoted poorly reliable in supporting the comorbid association of PD and assumed "primary" RLS. Because of these considerations, it would have been preferable to have titled the paper by Peralta et al. "Restless Legs-like Syndrome in Parkinson's Disease.
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