Oxidative stress and autonomic nervous system functions in restless legs syndrome.
BACKGROUND
Oxidative stress has been implicated in over 100 disorders in recent years; however, the situation in restless legs syndrome (RLS) has not been studied yet.


METHODS
Fifty patients with RLS not medicated for RLS and 50 sex- and age-matched, healthy controls and controls with no pathology except mild iron deficiency or iron deficiency anaemia were enrolled. Patients with secondary RLS other than iron deficiency were excluded. Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), arylesterase (ARE), paraoxonase (PON), stimulated paraoxonase (stim-PON), lipid hydroperoxides (LOOHs), acetyl cholinesterase (AChE) and butyryl cholinesterase (BuChE) were measured. Heart rate variability (HRV) analysis was performed.


RESULTS
TOS, ARE and AChE were increased (P = 0·018, P < 0·001 and P < 0·001, respectively), whereas LOOHs were decreased (P < 0·001) in RLS group. TAS, OSI, PON and stim-PON were comparable. Erythrocyte sedimentation rate (ESR) and mean platelet volume (MPV) were increased (P = 0·021 and P = 0·037, respectively) in RLS group. HRV triangular index (HRVi) was lower (P = 0·012) in RLS group. Other HRV parameters were similar.


CONCLUSIONS
Increased AChE and decreased LOOHs, which were influenced by increased PON1, were considered as indicators of efforts towards the protection of dopaminergic activity in central nervous system in RLS group. Increased ESR, MPV and low HRVi indicate elevated sympathetic activity in RLS group. Elevated sympathetic activity might be beneficial in relieving RLS symptoms, also causing increases in TOS. The evidence we found regarding oxidative stress and autonomic nervous system might be seminal in RLS treatment.
Internal Medicine Clinic, Vakif Gureba Training and Research Hospital, Fatih, Istanbul, Turkey. malicikrikcioglu@yahoo.com
Mehmet Ali
MA
Cikrikcioglu
Mehmet
M
Hursitoglu
Hafize
H
Erkal
Burcin Erdem
BE
Kınas
Juan
J
Sztajzel
Mustafa
M
Cakirca
Aysun Guneri
AG
Arslan
Aybala
A
Erek
Gulistan
G
Halac
Tufan
T
Tukek
D000110:Acetylcholinesterase / Q000097:blood; D000328:Adult; D000375:Aging / Q000097:blood; D018798:Anemia, Iron-Deficiency / Q000150:complications; D043303:Aryldialkylphosphatase / Q000097:blood; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001799:Blood Sedimentation; D002265:Carboxylic Ester Hydrolases / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000090463:Iron Deficiencies; D008054:Lipid Peroxides / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D012148:Restless Legs Syndrome / Q000097:blood / Q000503:physiopathology*
D008054:Lipid Peroxides; D008055:Lipids; D002265:Carboxylic Ester Hydrolases; C019734:arylesterase; D000110:Acetylcholinesterase; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human