帕金森病不宁腿综合征患者的患病率和临床特征:一项荟萃分析

IF 3.8 2区 医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2024-07-15 DOI:10.1016/j.sleep.2024.07.015
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引用次数: 0

摘要

导言:不宁腿综合征(RLS)是一种睡眠/觉醒调节的感觉运动障碍,其特征是有移动双腿的冲动,并伴有多种感觉症状,主要影响下肢。帕金森病(PD)患者的 RLS 发生率增加,并且与严重的运动和非运动表现相关。我们的目的是对帕金森病(PD)中 RLS 的发病率及其相关临床特征(PD-RLS)进行可靠的估计。方法我们使用 PubMed、Scopus 和 PsycINFO 数据库对截至 2024 年 1 月的文献进行了系统性检索。如果文章提供了患有或不患有 RLS 的 PD 患者的数据,则将其纳入其中,并使用这些比例来估算 PD-RLS 的患病率。通过比较有 RLS 和无 RLS 的 PD 患者的临床特征,探讨了与 PD-RLS 相关的临床概况。在6 990名PD患者样本中,RLS的总患病率为20%,且与女性性别、混合运动表型、更严重的运动障碍和功能障碍以及睡眠障碍、认知和自主神经功能障碍等多种非运动症状和更严重的神经精神表现有关。敏感性分析表明,PD-RLS与多巴胺能治疗相关变量有显著关联。结论 PD-RLS 的患病率超过了普通人群的患病率,这表明这两种疾病之间存在某种关系。多巴胺能治疗似乎在缓解、恶化或 "模仿 "RLS表现方面起着矛盾的作用。然而,PD-RLS 患者的临床特征是非运动症状更为严重,这也表明多巴胺能以外的神经递质系统也参与了 PD-RLS 的病因学研究。
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Prevalence and clinical profile of patients with restless legs syndrome in Parkinson's disease: A meta-analysis

Introduction

Restless legs syndrome (RLS) is a sensorimotor disorder of sleep/wake regulation characterized by an urge to move the legs accompanied by a wide range of sensory symptoms, mainly affecting the lower limbs. An increased incidence of RLS has been demonstrated in Parkinson's disease (PD) and has been associated with severe motor and non-motor manifestations. We aimed to provide a reliable estimate of RLS prevalence and the clinical features associated with its occurrence in PD (PD-RLS).

Methods

We performed a systematic literature search up to January 2024 using PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with or without RLS, and these proportions were used to estimate the prevalence of PD-RLS. Clinical profile associated with PD-RLS was explored by comparing the clinical characteristics of PD patients with and without RLS.

Results

Forty-six studies were included in the meta-analysis. Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients and was associated with female sex, mixed motor phenotype, worse motor disturbances and functional disability, and a wide range of non-motor symptoms such as sleep disorders, cognitive and autonomic dysfunctions, and more severe neuropsychiatric manifestations. Sensitivity analyses indicated significant associations of PD-RLS with variables related to dopaminergic therapy. No association was found with serum ferritin, serum iron and hemoglobin levels.

Conclusions

The prevalence of PD-RLS exceeds that reported in the general population, suggesting the existence of a relationship between the two disorders. Dopaminergic treatment seems to play an ambivalent role relieving, worsening or “mimicking” RLS manifestations. However, the clinical profile of PD-RLS patients, characterized by a greater severity of non-motor symptoms, also suggests that neurotransmitter systems other than the dopaminergic one are involved in PD-RLS etiology.

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来源期刊
Sleep medicine
Sleep medicine 医学-临床神经学
CiteScore
8.40
自引率
6.20%
发文量
1060
审稿时长
49 days
期刊介绍: Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.
期刊最新文献
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