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Restless Legs Syndrome: Would You Like That with Movements or Without? Cover

Restless Legs Syndrome: Would You Like That with Movements or Without?

By: Brian B. Koo  
Open Access
|Jul 2015

Figures & Tables

Table 1

International Restless Legs Syndrome Study Group Consensus Diagnostic Criteria for RLS

1) An urge to move the legs usually but not always accompanied by, or felt to be caused by, uncomfortable and unpleasant sensations in the legs.
2) The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting.
3) The urge to move the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
4) The urge to move the legs and any accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening or night rather than during the day.
5) The occurrence of the above features is not solely accounted for as symptoms primary to another medical or behavioral condition (e.g., myalgia, venous stasis, leg edema, arthritis, leg cramps, positional discomfort, habitual foot tapping).
A. Chronic-persistent RLS/WED: symptoms when not treated would occur on average at least twice weekly for the past year.
B. Intermittent RLS/WED: symptoms when not treated would occur on average

[i] Abbreviations: RLS, Restless Legs Syndrome; WED, Willis Ekbom Disease.

Table 2

Similarities between Restless Legs Syndrome and Periodic Limb Movements during Sleep

Restless Legs SyndromePeriodic Limb Movements During Sleep
Pathophysiology
  • Possibly involvement of A11 dopaminergic system, which is located in the spinal cord.19

  • Decreased dopamine-2 receptor expression in putamen.22

  • Emerge likely spinal cord generator as evidenced by pattern of recruitment of muscles, which is rostral to caudal or caudal to rostral in lumbar and sacral myotomes.17

  • Decreased urinary dopamine.23

Pharmacology
  • Symptoms of RLS are decreased by dopamine agonists.24

  • D3-receptor agonists more effective than D2-receptor agonists.27

  • Symptom worsening by antidepressants.30

  • PLMS are decreased by dopamine agonists.25,26

  • D3-receptor agonists more effective than D2-receptor agonists.27

  • PLMS become more frequent with antidepressants.28

Genetics
  • Associated with BTBD9.31

  • TOX3/BC034767.32

  • MEIS1.32

  • MAP2K5/SKOR1.32

  • PTPRD.33

  • Associated with BTBD9.31

  • TOX3/BC034767.34

  • MEIS1.34

  • MAP2K5/SKOR1.34

  • PTPRD.34

Epidemiology
  • Around 10% prevalence.36

  • More common in older individuals

  • Around 10% prevalence.4

  • More common in older individuals

[i] Abbreviations: MAP2KD, Mitogen-Activated Protein Kinase Kinase 5; PLMS, Periodic Limb Movements during Sleep; PTPRD, Protein Tyrosine Phosphatase Receptor Type D; RLS, Restless Legs Syndrome.

tre-05-316-6775-1-g001.jpg
Figure 1

Periodic Limb Movements during Sleep. Pictured is a 2-minute epoch that shows periodic limb movements during sleep (PLMS), which occur every 20–30 seconds. Electroencephalographic activations and accelerations in heart rate occur at the same time as PLMS.

DOI: https://doi.org/10.5334/tohm.280 | Journal eISSN: 2160-8288
Language: English
Submitted on: Apr 6, 2015
Accepted on: Apr 30, 2015
Published on: Jul 1, 2015
Published by: Columbia University Libraries/Information Services
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2015 Brian B. Koo, published by Columbia University Libraries/Information Services
This work is licensed under the Creative Commons License.