title: Defining the boundaries of the response of sleep leg movements to a single dose of dopamine agonist.
abstract: OBJECTIVE
  To define which leg movements (LM) associated with restless legs syndrome (RLS) respond to dopamine-agonist treatment and verify if they fall within current diagnostic criteria for periodic LM during sleep (PLMS).
  
  
  METHODS
  Single-blind placebo-controlled study.
  
  
  METHODS
  Sleep laboratory.
  
  
  METHODS
  43 consecutive untreated patients with idiopathic restless legs syndrome.
  
  
  METHODS
  Patients underwent clinical and neurophysiological evaluation, hematological screening, and 2 consecutive full-night polysomnographic studies. Before the second polysomnographic study, all patients were randomized to receive 0.25 mg of pramipexole or placebo.
  
  
  RESULTS
  LM parameters such as duration, amplitude, interval, and periodicity were analyzed. Compared to placebo, pramipexole significantly (P < 0.01) reduced PLMS while increasing sleep efficiency. Specifically we observed a significant (P < 0.01) reduction in LM ranging 2-4 s in duration and with intermovement interval of 6-46 s and a significant decrease in the periodicity of motor events. No effect of pramipexole was observed on isolated LM.
  
  
  CONCLUSIONS
  These results support a heterogeneous basis for LM in RLS patients; while isolated LM do not respond to pramipexole treatment, most, but not all, PLMS classified by means of the current criteria do. Further studies with different pramipexole doses or dopamine agonists with different receptor-binding preference are warranted to better define the borders of dopamine response of PLMS.
authors.affiliation: Sleep Disorders Center, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Vita-Salute University, Milan, Italy. manconi.mauro@hsr.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Manconi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.forename: Thom R
authors.initials: TR
authors.lastname: Feroah
authors.forename: Marco
authors.initials: M
authors.lastname: Zucconi
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
mesh_terms: D000328:Adult; D000368:Aged; D052160:Benzothiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D003196:Computer Graphics; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D017286:Polysomnography / Q000187:drug effects; D000077487:Pramipexole; D011446:Prospective Studies; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D016037:Single-Blind Method
chemical_list: D052160:Benzothiazoles; D018491:Dopamine Agonists; D000077487:Pramipexole
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