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Comparison between patients and controls.

Comparison between patients and controls.

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Background: Restless Legs Syndrome (RLS) is associated with impaired central dopaminergic neurotransmission. Though a link between RLS and parkinsonism has been proposed, the prevalence of RLS in parkinsonian disorders is poorly documented. Objective: To determine the prevalence of RLS in patients with Parkinson's Disease (PD), Progressive Supra...

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... general, patients showed higher PSQI and ESS scores than controls (p < 0.001) ( Table 1). These scores were higher in atypical parkinsonian disorders than in PD patients (Table 2) though the difference did not reach statistical significance. ...
Context 2
... comparison of patients and controls is summarised in Table 1. ...

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Citations

... This suggests that males and females with PD share similar predisposition to RLS and OSA. However, some studies have reported notable differences in RLS among their cohorts (22,23), indicating potential sex differences dependent on additional factors such as environmental exposures. ...
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Parkinson’s disease (PD) is a neurodegenerative disorder affecting 10 million people worldwide. PD results in both motor and non-motor symptom manifestations. Notably, sleep disorders are one of the most common non-motor symptoms of PD and exhibit sex differences in frequency and severity. Although studies have identified variations in sleep disorder manifestation and genetic variants between male and female PD patients, few have examined the connection between PD sleep disorders and genetic risk factors with consideration of biological sex. To address the hypothesis that sex-specific sleep dysfunction in PD patients is associated with genetic risk variants, this study compares sleep symptom frequency and PD-associated genetic variants between males and females. The findings of this study reveal that the differential prevalence of a leucine-rich repeat kinase 2 (LRRK2) mutation (G2019S) between male and female PD patients may underlie sex differences in PD sleep disorders, including rapid eye movement (REM) behavior disorder (RBD) and insomnia. This suggests the potential of sex-specific genetic treatments in effectively managing the sleep symptoms of PD patients.
... In the general population, RLS commonly leads to sleep disturbances and may have a negative impact on quality of life, though it represents an underdiagnosed syndrome [19]. In PwPD, RLS has been reported to impair sleep parameters and quality of sleep [20,21]. Previous studies have also demonstrated an association between RLS and anxiety and depression [22,23]. ...
... For each question, possible answers ranged from 4 (very severe) to 0 (none). The total IRLS score was used for establishing the severity of RLS: very severe (>31), severe (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and mild (0-10) [26]. Sleep characteristics were assessed with several validated scales. ...
... On the contrary, Krishan et al. [47] reported more RLS symptoms in older patients, while Nomura et al. [48] identified RLS in younger people. Previous studies have not found significant differences in the severity of PD assessed by H&Y stages between patients with and without the diagnosis of RLS [20,46,47], but this aspect is under controversy as well. Swensson et al. observed a higher frequency of RLS symptoms in stages 1 and 2 H&Y compared with stages 3 and 4, but patients with advanced PD (H&Y 5) were not included in the study [39]. ...
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Background: Restless legs syndrome (RLS) might worsen sleep quality and quality of life in people with Parkinson's disease (PwPD). Objective: The main aim of the present study is to explore the associations between RLS and sleep, quality of life and other non-motor symptoms (NMS) in a sample of PwPD. Methods: We compared the clinical features of 131 PwPD with and without RLS, in a cross-sectional study. We used several validated scales for assessment: the International Restless Legs Syndrome Study Group rating scale (IRLS), Parkinson's Disease Sleep Scale version 2 (PDSS-2), Parkinson's Disease Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQ) and International Parkinson and Movement Disorder Society Non-Motor Rating Scale (MDS-NMS). Results: Thirty-five patients (26.71%) out of the total PwPD met the RLS diagnostic criteria, without significant differences between male (57.14%) and female (42.87%) (p = 0.431). Higher total scores of PDSS-2 were recorded among PwPD + RLS (p < 0.001), suggesting worse sleep quality. Significant correlations were observed between the diagnosis of RLS and some types of pain (especially nocturnal pain), physical fatigue and probable sleep-disordered breathing, according to the MDS-NMSS assessment. Conclusions: RLS has a high frequency in PwPD and it requires proper management, considering its consequences on sleep and quality of life.
... Deterioration of night sleep quality was reported to be associated with RBD [78] and RLS [79]. However, some studies demonstrated no difference in subjective sleepiness between PD patients with or without RBD and RLS [80]. Moreover, the deterioration of night sleep quality can be produced by anxiety and depression, and cognitive dysfunction in PD patients [63]. ...
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... Leg restlessness is a frequent symptom in PD and the epidemiological link between PD, leg restlessness and RLS is complex, as the prevalence of RLS in PD shows diverging results ranging from 0 to 50% (13), with prospective studies identifying a more trustable prevalence of 10-20% (14). Such variability is mainly caused by the heterogeneity of methods used for RLS screening: from having the symptom of "irresistible desire to move the legs, particularly at night" used in the former data on prevalence (15), to the use of the IRLSSG diagnostic criteria (which have undergone two revisions since their first publication in 1995) in the latter (16). ...
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Background Non-motor manifestations are the main features of Parkinson's disease (PD). These have been associated with vitamin D abnormalities, but the role of parathormone (PTH) is still obscure. Among the non-motor symptoms of PD, the pathogenesis of restless leg syndrome (RLS) is still debated, but it has been associated with the vitamin D/PTH axis in other disease models. Our study deepens the association between vitamin D and PTH with the prevalence of non-motor symptoms of PD and explores such a relationship in patients reporting leg restlessness. Methods Fifty patients with PD were extensively investigated with motor and non-motor scales. Data on serum levels of vitamin D, PTH, and related metabolites were obtained, and patients were stratified as having vitamin D deficiency or hyperparathyroidism according to standardized criteria. Results Overall, 80% of patients with PD exhibited low vitamin D levels, and hyperparathyroidism was diagnosed in 45%. The analysis of the non-motor symptoms profile using the non-motor symptom questionnaire (NMSQ) revealed 36% of leg restlessness, a main feature of RLS. This was significantly associated with worse motor symptoms, quality of sleep, and quality of life. Moreover, it was associated with hyperparathyroidism (OR: 3.48) and with PTH levels, independent of vitamin D, calcium/phosphate levels, and motor status. Conclusion Our results suggest a significant association between the vitamin D/PTH axis and leg restlessness in PD. PTH has a putative role in nociceptive modulation, and previous evidence on hyperparathyroidism has suggested a possible interrelation with RLS. Further investigations are necessary to add PTH to the non-dopaminergic non-motor landscape of PD.
... In India, it is estimated that there are currently around 4 million people living with dementia, and this number is expected to increase to around 7.7 million by 2030 (Chowdhary et al., 2021;Parle et al., 2005;Verma & Asopa, 2018). The prevalence of dementia in South Asia was 1.9% in 2005, and in 2020 it was 3.6 million and expected to rise by7.5 million by 2040 (Bhalsing et al., 2013;Ru et al., 2021;Salahuddin et al., 2020). Dementia has a varied incidence rate in India, ranging from 2 per 1000 to 35 per 1000 people, according to epidemiological studies (de Villiers, 1983;Lakshman et al., 2016;Taquet et al., 2022). ...
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... In the context of PD, RLS is more frequently observed with a prevalence of 14% [57]. RLS is rarely reported in patients with multiple system atroph (MSA), progressive supranuclear palsy and HD [58][59][60]. The relatively high prevalence of RLS in PD may be attributed to the common dysfunction of the dopaminergic system as some researchers proposed [61]. ...
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Disruptions of circadian rhythms and sleep cycles are common among neurodegenerative diseases and can occur at multiple levels. Accumulating evidence reveals a bidirectional relationship between disruptions of circadian rhythms and sleep cycles and neurodegenerative diseases. Circadian disruption and sleep disorders aggravate neurodegeneration and neurodegenerative diseases can in turn disrupt circadian rhythms and sleep. Importantly, circadian disruption and various sleep disorders can increase the risk of neurodegenerative diseases. Thus, harnessing the circadian biology findings from preclinical and translational research in neurodegenerative diseases is of importance for reducing risk of neurodegeneration and improving symptoms and quality of life of individuals with neurodegenerative disorders via approaches that normalize circadian in the context of precision medicine. In this review, we discuss the implications of circadian disruption and sleep disorders in neurodegenerative diseases by summarizing evidence from both human and animal studies, focusing on the bidirectional links of sleep and circadian rhythms with prevalent forms of neurodegeneration. These findings provide valuable insights into the pathogenesis of neurodegenerative diseases and suggest a promising role of circadian-based interventions.
... This proves that basal ganglia are not only involved in the somatomotor loop but also in the occulomotor loop of frontal sub cortical circuit. 15 Increased speech impairment, restless leg syndrome (RLS), 16 impulse control disorders, 17 both obstructive and restrictive patterns of respiratory n -Control = 30; Intervention = 30 dysfunction were very common in PD. 18 Decreased response of heart rate and blood pressure to autonomic stimulation revealed the presence of cardiac autonomic dysfunction in PD patients. 19 It was reported that the combined effect of reduction in muscle strength, decreased proprioception, visual sense, and narrow base of support leads to the imbalance in PD. 20 Ayurvedic treatment like cleansing or eliminating therapy (panchakarma) followed by mixture of cow's milk, Mucunapruriens, Hyoscyamusreticulatus seeds, Withaniasomnifera, and Sidacordifolia roots were useful to improve the activities of daily living in PD patients. ...
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Background: The existing treatments for PD were associated with side effects and does not offer complete cure. Hence there is a need of alternative therapy which can prevent or delay the onset of PD with less or no side effects. Aim and objective: The overall objective of the present study was to assess the effectiveness of electrical vestibular nerve stimulation in the management of Parkinson’s disease. Materials and methods: 60 cases with PD, including both males and females, were recruited in the study by convenient sampling after obtaining written and informed consent. They were randomly grouped with 30 participants in each group. Control group received sham stimulation and the intervention group received electrical vestibular nerve stimulation for 12 weeks. After recording the baseline biochemical parameters, post intervention assessment was performed after 6 weeks and 12 weeks of intervention and compared. Results: Demographic variables were not statistically significant among the control and intervention groups. There was a significant increase in the dopamine and GABA levels followed by the intervention. Conclusion: The present study results support the positive impact of non-invasive electrical vestibular nerve stimulation in modulating neurotransmitters in patients with Parkinson’s disease. A further detailed translational study is required in this area with a larger sample size to generalize the results.
... The estimated prevalence of RLS varies widely depending on the selected study population between 1% and 24% [229]. Whether the prevalence of RLS is elevated in PD compared to the general population still needs to be finally determined [230][231][232]. However, current evidence suggests a similar prevalence of RLS in de novo PD patients compared to the general population with increasing numbers associated with dopaminergic treatment and disease progression [86,229] as well as age and female sex [233]. ...
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Parkinson’s disease (PD) is defined by its motor symptoms rigidity, tremor, and akinesia. However, non-motor symptoms, particularly autonomic disorders and sleep disturbances, occur frequently in PD causing equivalent or even greater discomfort than motor symptoms effectively decreasing quality of life in patients and caregivers. Most common sleep disturbances in PD are insomnia, sleep disordered breathing, excessive daytime sleepiness, REM sleep behavior disorder, and sleep-related movement disorders such as restless legs syndrome. Despite their high prevalence, therapeutic options in the in- and outpatient setting are limited, partly due to lack of scientific evidence. The importance of sleep disturbances in neurodegenerative diseases has been further emphasized by recent evidence indicating a bidirectional relationship between neurodegeneration and sleep. A more profound insight into the underlying pathophysiological mechanisms intertwining sleep and neurodegeneration might lead to unique and individually tailored disease modifying or even neuroprotective therapeutic options in the long run. Therefore, current evidence concerning the management of sleep disturbances in PD will be discussed with the aim of providing a substantiated scaffolding for clinical decisions in long-term PD therapy.
... 48,49,55 Only one study assessed circadian rhythms, 56 where DLB core body temperature was measured alongside PSG. 56 Three studies focussed on PLMs or RLS 57-59 using clinical evaluation and subjective measures, 57 or objective PSG measures of PLMs. 58,59 The latter study also measured aspects of sleep-disordered breathing. ...
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Background: Lewy body dementia (LBD) refers to both dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). Sleep disturbances are common in LBD, and can include poor sleep quality, excessive daytime sleepiness (EDS), and rapid eye movement behaviour disorder (RBD). Despite the high clinical prevalence of sleep disturbances in LBD, they are under-studied relative to other dementias. The aim of the present systematic review was to examine the nature of sleep disturbances in LBD, summarise the effect of treatment studies upon sleep, and highlight specific and necessary directions for future research. Methods: Published studies in English were located by searching PubMED and PSYCArticles databases (until 10 June 2022). The search protocol was pre-registered in PROSPERO (CRD42021293490) and performed in accordance with PRISMA guidelines. Results: Following full-text review, a final total of 70 articles were included. These included 20 studies focussing on subjective sleep, 14 on RBD, 8 on EDS, 7 on objective sleep, and 1 on circadian rhythms. The majority of the 18 treatment studies used pharmacological interventions (n = 12), had an open-label design (n = 8), and were of low-to-moderate quality. Most studies (n = 55) included only patients with DLB. Due to the heterogeneity of the studies, we reported a narrative synthesis without meta-analysis. Conclusions: At least one form of sleep disturbance may be present in as many as 90% of people with LBD. Subjectively poor sleep quality, excessive daytime sleepiness, and RBD are more common and severe in LBD relative to other dementias.
... Additionally, post-mortem data have not shown evidence of alpha-synucleinopathy in RLS [6], and genetic studies similarly have suggested divergent diathesis for the two conditions [7][8][9]. Despite this considerable evidence of their relative independence, many case-control studies have shown higher prevalence of RLS in PD than in controls (e.g., [10][11][12][13]), though some studies do not concur and imply that prior exposure to dopaminergic medications may underly the apparently higher prevalence of RLS in PD (e.g., [14][15][16]). Recent reviews [17][18][19] have described this complex, and often conflicting, literature in greater detail. ...
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Background The association between restless legs syndrome (RLS) and Parkinson’s disease (PD) remains controversial, with epidemiologic and descriptive evidence suggesting some potential overlap while mechanistic/genetic studies suggesting relative independence of the conditions. Objective To examine a known, objectively measured endophenotype for RLS, periodic leg movements (PLMS) in sleep, in patients with PD and relate that objective finding to restless legs symptoms. Methods We performed polysomnography for one (n = 8) or two (n = 67) consecutive nights in 75 PD patients and examined the association of PLMS with restless legs symptoms. Results We found no association between restless legs symptoms and PLMS in PD. Prevalence of both was similar to data reported previously in other PD samples. Conclusion We interpret these results as suggesting that restless legs symptoms in PD patients may represent a different phenomenon and pathophysiology than RLS in the non-PD population.