Chronic Illness Increases Risk of Restless Legs Syndrome

MedicalResearch.com Interview with:
András Szentkirályi, MD, PhD
Research fellow:Westfälische Wilhelms-Universität Münster
Institut für Epidemiologie und Sozialmedizin
Germany, D-4814

MedicalResearch: What are the main findings of the study?

Dr. Szentkirályi : Based on two prospective, population-based cohort studies, we found that subjects having multiple chronic diseases are at an increased risk of suffering from restless legs syndrome (RLS). Moreover, increased multimorbidity was a significant predictor of developing new onset RLS. It is important to note that the observed relationship was not reduced when well-established causes of secondary restless legs syndrome (e.g. chronic renal disease) were excluded.

MedicalResearch: Were any of the findings unexpected?

Dr. Szentkirályi : It had been known that restless legs syndrome is related to specific chronic diseases, but the causality is unclear. While it is assumed that RLS may contribute to problems like hypertension or cardiovascular diseases, a reverse causality, as suggested by our data, might be somewhat surprising. Furthermore, we propose that the burden of multimorbidity, regardless of the specific composition of diseases, is important in the development of restless legs syndrome. To our knowledge, the potential role of multimorbidity has not been investigated in this context.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Szentkirályi : RLS is a frequent, but relatively underdiagnosed disorder. From a clinical point of view, it is important that medical professionals seeing patients with multiple chronic diseases should be able to recognise restless legs syndrome symptoms.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Szentkirályi : Our knowledge of restless legs syndrome  pathomechanism is incomplete. The results suggest that multiple chronic diseases can somehow contribute to the development of RLS, and the exact mechanism should be further studied. Some potential pathways include altered dopamine and/or iron homeostasis of the brain, injured peripheral nervous system, sympathetic hyperactivity, common genetic predisposition, chronic inflammation, etc.

Another important issue to study is the potential effect of the treatments of these chronic diseases on the course of restless legs syndrome.

Citation:

András Szentkirályi, MD, PhD, Henry Völzke, MD, Drmed, Wolfgang Hoffmann, MD, Drmed, MPH, Claudia Trenkwalder, MD, Drmed and Klaus Berger, MD, Drmed, MPH, MSc

Published online before print May 7, 2014, doi: 10.1212/WNL.0000000000000470 Neurology 10.1212/WNL.0000000000000470