Defining the boundaries of the response of sleep leg movements to a single dose of dopamine agonist.
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.
Manconi
Mauro
M
Sleep Disorders Center, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Vita-Salute University, Milan, Italy. manconi.mauro@hsr.it
Ferri
Raffaele
R
Feroah
Thom R
TR
Zucconi
Marco
M
Ferini-Strambi
Luigi
L
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
D052160:Benzothiazoles; D018491:Dopamine Agonists; D000077487:Pramipexole
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