Abstract
Based on recent data about the association between restless legs syndrome (RLS) and migraine, we performed an observational study on the occurrence of RLS in patients affected by primary headaches. Two hundred headache patients (149 women and 51 men) and 120 (90 women and 30 men) sex-and age-matched control subjects were included. In the headache group, migraine without aura (MO) was the most represented headache type (n=114), followed by the “mixed” group (n=40) with MO, migraine with aura (MA) and frequent episodic tension-type headache (ETTH) in various combinations, and by ETTH alone (n=22). The remaining patients suffered from MA alone (n=10 MA), episodic cluster headache (ECH n=12) and primary stabbing headache (n=2). RLS frequency was significantly higher in headache patients than in control subjects (22.4% vs. 8.3, p=0.002) independently of sex, although with a female preponderance (84%) in both groups. More than 60% (n=27) of RLS patients were affected by MO and 30% (n=13) by a combination of two headache types (p≥0.001), with a very low frequency of RLS for the other types of headache. No RLS patient had ECH. No statistical differences were observed among clinical characteristics of different types of headache in groups with and without RLS. In both headache and control groups, higher scores for depression and anxiety were more frequent in subjects with RLS compared with those without RLS. Furthermore, headache patients with RLS reported sleep disturbances more frequently compared to those without RLS (50.0% vs. 32.7%; p<0.0001) and showed a normal or underweight body mass index. Our data seem to confirm the existence of an association between RLS and primary headaches, particularly with migraine, as already demonstrated. The absence of RLS in ECH patients is very interesting. Many pathogenetic considerations about links between RLS and primary headaches could be given, the most fitting involving dopamine and melatonin.
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References
Biary N, Koller W, Langenberg P (1990) Correlation between essential tremor and migraine headache. J Neurol Neurosurg Psychiatry 53:1060–1062
Kwak C, Vuong KD, Jankovic J (2003) Migraine headache in patients with Tourette syndrome. Arch Neurol 60:1595–1598
Teixera AL Jr, Meira FC, Maia DP et al (2004) Migraine headache in patients with Sydenham’s chorea. Cephalalgia 25:542–544
Barbanti P, Fabbrini G (2002) Migraine and the extrapyramidal system. Cephalalgia 22:2–11
Rains JC, Poceta JS (2006) Headache and sleep disorders: review and clinical implications for headache management. Headache 46:1344–1363
Rhode AM, Hösing VG, Happe S et al (2007) Comorbidity of migraine and restless legs syndrome — a case-control study. Cephalalgia 27:1255–1260
Ekbom KA (1945) Restless legs. A clinical study. Acta Med Scand 158[Suppl]:1–123
Walters AS, for the International Restless Legs Syndrome Study Group (1995) Toward a better definition of restless legs syndrome. Mov Disord 10:634–642
Allen RP, Hening WA, Montplaisir J et al (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119
Phillips B, Young T, Finn L et al (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160:2137–2141
Zucconi M, Ferini-Strambi L (2004) Epidemiology and clinical findings of restless legs syndrome. Sleep Med 5:293–299
Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. Cephalalgia 24[Suppl 1]:9–160
American Academy of Sleep Medicine (2005) International Classification of Sleep Disorders: Diagnostic and Coding Manual, 2nd Edn. American Academy of Sleep Medicine, Westchester, IL
Hamilton M (1960) A rating scale for anxiety. J Neurol Neurosurg Psychiatry 23:56–62
Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the Beck Depression Inventory. Twenty-five years of evaluation. Clin Psychol Rev 8:77–100
Allen RP, Walters AS, Montplaisir J et al (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165:1286–1292
Bjorvatn B, Leissner L, Ulfberg J et al (2005) Prevalence, severity and risk factors of restless legs syndrome in the general adult population in two Scandinavian countries. Sleep Med 6:307–312
Sevim S, Dogu O, Kaleagasi H et al (2004) Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population based survey. J Neurol Neurosurg Psychiatry 75:226–230
Ulfberg J, Nystrom B, Carter N, Edling C (2001) Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic disease and neuropsychiatric symptoms. Mov Disord 16:1159–1163
Torelli P, Beghi E, Manzoni GC (2005) Cluster headache prevalence in the Italian general population. Neurology 64:469–474
Entezari T, Singleton JR, Jones CR et al (1999) Changes in excitability of motor cortical circuitry in primary restless legs syndrome. Neurology 53:1201–1205
Brighina F, Piazza A, Daniele O, Fierro B (2002) Modulation of visual cortical excitability in migraine with aura: effects of 1 Hz repetitive transcranial magnetic stimulation. Exp Brain Res 145:177–181
Allen R (2004) Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med 5:385–391
Wetter TC, Eisensehr I, Trenkwalder C (2004) Functional neuroimaging studies in restless legs syndrome. Sleep Med 5:401–406
Fanciullacci M, Alessandri M, Del Rosso A (2000) Dopamine involvement in the migraine attack. Funct Neurol 15[Suppl 3]:171–181
Michaud M, Dumont M, Selmaoui B et al (2004) Circadian rhythm of restless legs syndrome: relationship with biological markers. Ann Neurol 55:372–380
Waldenlind E, Gustafsson S, Ekbom K, Wetterberg L (1987) Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission. J Neurol Neurosurg Psychiatry 50:207–213
Leone M, Lucini V, D’Amico D et al (1995) Twenty-four-hour melatonin and cortisol plasma levels in relation to timing of cluster headache. Cephalalgia 15:224–229
Ondo WG, He Y, Rajasekaran S, Le WD (2000) Clinical correlates of 6-hydroxydopamine injections into A11 dopaminergic neurons in rats: a possible model for restless legs syndrome. Mov Disord 15:154–158
Welch KM, Nagesh V, Aurora SK, Gelman N (2001) Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness? Headache 41:629–637
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d’Onofrio, F., Bussone, G., Cologno, D. et al. Restless legs syndrome and primary headaches: a clinical study. Neurol Sci 29 (Suppl 1), 169–172 (2008). https://doi.org/10.1007/s10072-008-0916-3
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DOI: https://doi.org/10.1007/s10072-008-0916-3