Clinical features of Parkinson's disease with restless legs syndrome

Upload time:2017-02-23 Browse:

Author: Hu Yang Pu good Teng Hong Yu Shu Yang Li Lixia Zuo Lijun Yu Qiujin Wang Ruidan Guo Peng Liu Li Zhang Wei Jin
Abstract: Objective To investigate the clinical features, pathological changes of serum proteins and neurotransmitter levels in patients with Parkinson's disease (PD) complicated with restless legs syndrome (RLS). Methods 186 PD patients hospitalized in Beijing Tiantan Hospital for gerontology and neurology patients were divided into PD with RLS group (RLS group) and PD with RLS (NRLS) group, with restless legs syndrome Rating Scale (RLS-RS) clinical manifestations and evaluate the severity of RLS; using enzyme-linked immunosorbent assay for the detection of cerebrospinal fluid protein neuropathology (including alpha synuclein oligomers, different parts of total Tau and phosphorylated tau protein) level, chromatographic detection of CSF neurotransmitters by high performance liquid (including acetylcholine, dopamine, epinephrine and serotonin level 5-). To analyze the relationship between RLS-RS and pathological protein and neurotransmitter. Results (1) the incidence of RLS in patients with PD was 42.47%, and the course of RLS in group was significantly longer than that in group NRLS (P < 0.05). (2) the Hoehn-Yahr staging and UPDRS III score of RLS group were significantly higher than those of group NRLS (P < 0.05). (3) RLS patients with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh sleep quality index (PSQI) and fatigue severity scale (FSS) scores were higher than that of group NRLS (P < 0.01), and between the two groups of Montreal cognitive assessment (MoCA) improved apathy rating scale (MAES) and Ep Voss Faith Sleep Scale (ESS) score was not statistically significant difference (P > 0.05). (4) the levels of alpha synuclein oligomers in cerebrospinal fluid of RLS group were significantly higher than those in group NRLS (0.31 + ng/ ml + + 0.21 + ng/ml, P < 0.05). The RLS-RS score of RLS group was positively correlated with the level of alpha synuclein oligomer (r=0.355, P < 0.01). (5) the levels of dopamine and 5- HT in cerebrospinal fluid in group RLS were significantly lower than those in NRLS group (= + 3.67) pg/mL ratio (= + 4.85) pg/mL, P < < > > (= + 8.14) pg/mL ratio (= + 7.50) pg/mL, P < 0.01). There was a negative correlation between the severity of RLS-RS and the levels of dopamine and serotonin (5-) in cerebrospinal fluid (r=-0.274, P < 0.01); r=-0.360, P < 0.01) in group RLS. (6) there was no correlation between the levels of alpha synuclein oligomers and dopamine and serotonin (r=-0.119, P=0.362; r=-0.127; P=0.327) in cerebrospinal fluid (CSF). Conclusion RLS is one of the most common non motor symptoms of PD, PD with RLS patients with more severe motor symptoms, non motor symptoms of anxiety, depression, fatigue, sleep quality is worse. PD-RLS alpha synuclein oligomerization in brain may be the mechanism of PD-RLS, and dopamine deficiency may be the neurobiological basis of PD-RLS.
Key words: Parkinson's disease; restless legs syndrome; clinical features; alpha synuclein; neurotransmitter
CLC number: R742.5 document code: A article number: 1006-2963 (2017)
Parkinson 's disease with restless legs syndrome: clinical features, pathological proteins and neurotransmitters PIAO Yingshan, HU Yang, LI Lixia, LIAN Tenghong, YU Shuyang, ZUO Lijun, YU Qiujin, WANG Ruidan, GUO Peng, JIN Zhao, LIU Li, ZHANG Wei*. *Department of Geriatrics, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; National Clinical Research Center for Neurological Diseases, Beijing 100050, China Core Laboratory for Neurodegenerative Disease of; Ministry of Education, Beijing 100069, China; Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing Key Laboratory on Parkinson Disease Beijing, 100053, China
Corresponding author:ZHANG Wei, Email:ttyyzw@163.com
ABSTRACT: Objective To explore the relationships between restless legs syndrome (RLS) and clinical features, pathological proteins and neurotransmitters in patients with Parkinson disease (PD). Methods patients were collected and 186 PD divided into the RLS group and non-RLS (NRLS) groups according to the scores of RLS-RS and a comparison study was conducted by measuring pathological proteins (a -synuclein oligomer, total-Tau, phosphorylation-Tau) using enzyme linked immunosorbent assay (ELISA), and neurotransmitters (dopamine, acetylcholine, adrenaline and 5-hydroxytryptaphane using high-performance liquid) chromatography. Results (1) 42.47% of PD patients were accompanied with RLS. The RLS group had significantly longer disease dur Ation than the NRLS group (P < 0.05). (2) There were significant differences in Hoehn-Yahr Stage and UPDRS between the RLS and NRLS score groups (P < 0.05). (3) The scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), fatigue severity scale (FSS) and Pittsburgh Sleep Quality Index (PSQI) in the RLS group were significantly increased comparing with those in the NRLS group (P < 0.05). The scores of Montreal Cognitive Assessment (MoCA), modified indifference Rating Scale (MAES) and Epworth Sleeping Scale (ESS) were not significantly different between the two groups (P > 0.05). (4) -synuclein oligomer levels in cerebrospinal fluid alpha (CSF) in the PD-RLS group were elevated compared to PD-NRLS Group [(0.31 (0.09) ng/ mL vs. (+ + 0.08) ng/mL, P < 0.05). RLS-RS score increased with the elevated was -sy ()