Highlights
- •Considering the comorbidities that accompany MS, RLS is one of the most common.
- •To ascertain features and impact of RLS among PwMS we conducted a nation-wide survey.
- •Onset of RLS was before or synchronous with the onset of MS in half of our patients.
- •The pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.
- •MS should be included as one of the certain secondary causes of RLS.
Abstract
Background
Although studies report a high prevalence rate of restless legs syndrome (RLS) among
patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known
about the causes of this relationship.
Methods
To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide,
multicenter, prospective and a cross-sectional survey, designed to reflect all of
the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship
of the two conditions could possibly contribute to the understanding of the causes
of the high and wide-ranging prevalence rates and the pathophysiology of both diseases.
Results
Of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did
not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed
in terms of RLS. More than half of the patients with RLS had ‘severe’ or ‘very severe’
RLS. The onset of RLS was before or synchronous with the onset of MS in about a half
of our patients.
Conclusion
We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct
cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS
and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic
changes in the initial phases of MS can possibly trigger RLS symptoms.
Keywords
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References
- Prevalence of multiple sclerosis in the middle black sea region of Turkey and demographic characteristics of patients.Arch. Neuropsychiatr. 2017; 54: 11-14
- Quantitative spinal cord MRI in radiologically isolated syndrome.Neurol. Neuroimmunol. Neuroinflamm. 2018; 5: e436
- Increased frequency of restless legs syndrome in a French-Canadian population with multiple sclerosis.Neurol. 2005; 65: 1652-1653
- Restless legs syndrome in multiple sclerosis.Eur. Neurol. 2011; 65: 302-306
- Sex and the risk of restless legs syndrome in the general population.Arch. Intern. Med. 2004; 164: 196-202
- Prevalence of multiple sclerosis: door-to-door survey in three rural areas of coastal black sea regions of Turkey.Neuroepidemiol. 2011; 37: 231-235
- The underdiagnosis of sleep disorders in patients with multiple sclerosis.J. Clin. Sleep. Med. 2014; 10: 1025-1031
- Restless legs syndrome and multiple sclerosis: a population based case-control study in Catania.Sicily. Eur J Neurol. 2015; 22: 1018-1021
- Physical activity, sedentary behavior, and restless legs syndrome in persons with multiple sclerosis.J Neurol Sci. 2019; 15116531
- Restless legs syndrome and health-related quality of life in adults with multiple sclerosis.J Sleep Res. 2019; 3 (e): 12880
- Restless legs syndrome in multiple sclerosis: a case-control study.Mov. Disord. 2009; 24: 697-701
- Restless legs syndrome and multiple sclerosis: a Brazilian multicenter study and meta-analysis of the literature.Arq Neuropsiquiatr. 2011; 69: 180-183
- An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment.Curr. Opin. Neurol. 2014; 2: 493-501
- Prevalence of restless legs syndrome and REM sleep behavior disorder in multiple sclerosis.Mult. Scler. 2007; 13: 805-808
International Restless Legs Syndrome Study Group. 2012. IRLSSG diagnostic criteria for RLS. Available at: www.irlssg.org.
- The changing demographic pattern of multiple sclerosis epidemiology.Lancet Neurol. 2010; 9: 520-532
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurol. 1983; 33: 1444-1452
- Association of multiple sclerosis with restless legs syndrome and other sleep disorders in women.Neurol. 2012; 78: 1500-1506
- Restless leg syndrome and multiple sclerosis: a case-control study in China.Sleep Breath. 2015; 19: 1355-1360
- Cigarette smoking and the risk of multiple sclerosis: a sibling case-control study in Isfahan, Iran.Neuroepidemiol. 2011; 37: 238-242
- High prevalence of restless legs syndrome in multiple sclerosis.Eur. J. Neurol. 2007; 14: 534-539
- Multicenter case-control study on restless legs syndrome in multiple sclerosis: the REMS study.Sleep. 2008; 31: 944-952
- General health issues in multiple sclerosis:comorbidities, secondary conditions, and health behaviors.Continuum (MinneapMinn). 2013; 19: 1046-1057
- Emerging effects of comorbidities on multiple sclerosis.Lancet Neurol. 2010; 9: 820-828
- Higher prevalence of restless legs syndrome/Willis- Ekbom disease in multiple sclerosis patients is related to spinal cord lesions.Mult. Scler. Relat. Disord. 2017; 12: 54-58https://doi.org/10.1016/j.msard.2016.12.013
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the mcdonald criteria.Ann. Neurol. 2011; 69: 292-302
- Restless legs syndrome prevalence study-Methodology.Turk. J. Neurol. 2003; 9: 51-58
- Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey.Neurology. 2003; 61: 1562-1569
- Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population-based survey.J. Neurol. Neurosurg. Psychiatry. 2004; 75: 226-230
- Restless legs syndrome in Iranian multiple sclerosis patients: a case-control study.Int. J. Prev. Med. 2013; 4: 189-193
- Restless legs syndrome in multiple sclerosis.Sleep. Med. Rev. 2015; 22: 15-22
- Restless legs syndrome in multiple sclerosis.Turk. J. Med. Sci. 2015; 45: 1268-1273
- Epidemiology of restless legs syndrome in Turkish adults on the western black sea coast of Turkey: a door-to-door study in a rural area.Sleep Med. 2010; 11: 82-86
- Comorbidity in restless legs syndrome among a sample of Swedish adults.Sleep Med. 2007; 8: 768-772
- Smoking at time of CIS increases the risk of clinically definite multiple sclerosis.J. Neurol. 2018; 265: 1010-1015
- Restless legs syndrome in CZech patients with multiple sclerosis: an epidemiological and genetic study.Sleep Med. 2012; 13: 848-851
- Validation of the international restless legs syndrome study group rating scale for restless legs syndrome.Sleep Med. 2003; : 121-132
- Genetics of restless legs syndrome.Sleep Med. Rev. 2006; 10: 179-183
- Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis.Mult. Scler. 2016; 22: 782-791
Article info
Publication history
Published online: March 17, 2020
Accepted:
March 13,
2020
Received in revised form:
February 22,
2020
Received:
November 11,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
