Exploring the Relationship Between Parkinson Disease and Restless Legs Syndrome | Movement Disorders | JAMA Neurology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Earley  CJConnor  JRBeard  JLMalecki  EAEpstein  DKAllen  RP Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome.  Neurology.2000;54:1698-1700.Google Scholar
O'Keeffe  STGavin  KLavan  JN Iron status and restless legs syndrome in the elderly.  Age Ageing.1994;23:200-203.Google Scholar
Winkelman  JWChertow  GMLazarus  JM Restless legs syndrome in end-stage renal disease.  Am J Kidney Dis.1996;28:372-378.Google Scholar
Ondo  WJankovic  J Restless legs syndrome: clinicoetiologic correlates.  Neurology.1996;47:1435-1441.Google Scholar
Polydefkis  MAllen  RPHauer  PEarley  CJGriffin  JWMcArthur  JC Subclinical sensory neuropathy in late-onset restless legs syndrome.  Neurology.2000;55:1115-1121.Google Scholar
Goodman  JDBrodie  CAyida  GA Restless leg syndrome in pregnancy.  BMJ.1988;297:1101-1102.Google Scholar
Salih  AMGray  REMills  KRWebley  M A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis.  Br J Rheumatol.1994;33:60-63.Google Scholar
Ondo  WTan  EKMansoor  J Rheumatologic serologies in secondary restless legs syndrome.  Mov Disord.2000;15:321-323.Google Scholar
Phillips  BYoung  TFinn  LAsher  KHening  WAPurvis  C Epidemiology of restless legs symptoms in adults.  Arch Intern Med.2000;160:2137-2141.Google Scholar
Rothdach  AJTrenkwalder  CHaberstock  JKeil  UBerger  K Prevalence and risk factors of RLS in an elderly population: the MEMO study: Memory and Morbidity in Augsburg Elderly.  Neurology.2000;54:1064-1068.Google Scholar
Banno  KDelaive  KWalld  RKryger  MH Restless legs syndrome in 218 patients: associated disorders.  Sleep Med.2000;1:221-229.Google Scholar
Horiguchi  JInami  YNishimatsu  OInnami  TKakimoto  Y Sleep-wake complaints in Parkinson's disease [in Japanese].  Rinsho Shinkeigaku.1990;30:214-216.Google Scholar
Paulson  G Is restless legs a prodrome to Parkinson's disease [abstract]?  Mov Disord.1997;12(suppl 1):68. Google Scholar
Lang  AE Restless legs syndrome and Parkinson's disease: insights into pathophysiology.  Clin Neuropharmacol.1987;10:476-478.Google Scholar
Walters  ASfor the International Restless Legs Syndrome Study Group Toward a better definition of the restless legs syndrome.  Mov Disord.1995;10:634-642.Google Scholar
Johns  MW A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale.  Sleep.1991;14:540-545.Google Scholar
Ondo  W Ropinirole for restless legs syndrome.  Mov Disord.1999;14:138-140.Google Scholar
Earley  CJYaffee  JBAllen  RP Randomized, double-blind, placebo-controlled trial of pergolide in restless legs syndrome.  Neurology.1998;51:1599-1602.Google Scholar
Montplaisir  JDenesle  RPetit  D Pramipexole in the treatment of restless legs syndrome: a follow-up study.  Eur J Neurol.2000;7(suppl 1):27-31.Google Scholar
Wetter  TCCollado-Seidel  VPollmacher  TYassouridis  ATrenkwalder  C Sleep and periodic leg movement patterns in drug-free patients with Parkinson's disease and multiple system atrophy.  Sleep.2000;23:361-367.Google Scholar
Turjanski  NLees  AJBrooks  DJ Striatal dopaminergic function in restless legs syndrome: 18F-dopa and 11C-raclopide PET studies.  Neurology.1999;52:932-937.Google Scholar
Ruottinen  HMPartinen  MHublin  C  et al An FDOPA PET study in patients with periodic limb movement disorder and restless legs syndrome.  Neurology.2000;54:502-504.Google Scholar
Boyer  POndo  WAllen  R  et al Neuropathologic evaluation of the central nervous system in restless legs syndrome: case report and review of literature [abstract].  Soc Neurosci.2000;26(pt 2):2060. Google Scholar
Graham  JMPaley  MNGrunewald  RAHoggard  NGriffiths  PD Brain iron deposition in Parkinson's disease imaged using the PRIME magnetic resonance sequence.  Brain.2000;123(pt 12):2423-2431.Google Scholar
Ondo  WGHe  YRajasekaran  SLe  WD Clinical correlates of 6-hydroxydopamine injections into A11 dopaminergic neurons in rats: a possible model for restless legs syndrome.  Mov Disord.2000;15:154-158.Google Scholar
Jellinger  KA Pathology of Parkinson's disease: changes other than the nigrostriatal pathway.  Mol Chem Neuropathol.1991;14:153-197.Google Scholar
Kaasinen  VNagren  KHietala  J  et al Extrastriatal dopamine D2 and D3 receptors in early and advanced Parkinson's disease.  Neurology.2000;54:1482-1487.Google Scholar
Original Contribution
March 2002

Exploring the Relationship Between Parkinson Disease and Restless Legs Syndrome

Author Affiliations

From the Department of Neurology, Baylor College of Medicine, Houston, Tex.

Arch Neurol. 2002;59(3):421-424. doi:10.1001/archneur.59.3.421

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 (χ2 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.