title: L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children.
abstract: BACKGROUND
  In a previous open-label study, dopaminergic agents improved Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS), as well as Attention-Deficit-Hyperactivity Disorder (ADHD) in children with both disorders. We therefore conducted a double-blind placebo-controlled trial of L-DOPA in ADHD children with and without RLS/PLMS.
  
  
  METHODS
  Two groups of patients (total n = 29), those with ADHD only or those with ADHD and RLS/PLMS, were randomized to L-DOPA or placebo therapy. At baseline and after therapy patients were assessed with Conners' parent and teacher rating scales; polysomnography; RLS rating scale; and neuropsychometric measures of memory, learning, attention, and vigilance.
  
  
  RESULTS
  L-DOPA improved RLS/PLMS symptoms in all patients with those disorders compared with placebo (p = .007). When assessed by the Conners' Scales before therapy, ADHD was more severe in children without RLS/PLMS than in children with RLS/PLMS (p = 0.006). L-DOPA had no effect on Conners' scales, sleep, or neuropsychometric tests when all patients treated with the drug were compared to those on placebo or when patients with ADHD only were compared to those with ADHD and RLS/PLMS.
  
  
  CONCLUSIONS
  In this first double-blind study of a dopaminergic therapy in children with RLS/PLMS, L-Dopa significantly improved RLS/PLMS but not ADHD. These results, however, should be interpreted carefully since they may have been influenced by the relatively small sample size and the baseline differences in severity of ADHD symptoms. Further work needs to be done to elucidate the relationship between dopamine, ADHD and RLS/PLMS.
authors.affiliation: UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: England
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Picchietti
authors.forename: Barbara Vera
authors.initials: BV
authors.lastname: Couvadelli
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Fisher
authors.forename: Fouzia
authors.initials: F
authors.lastname: Siddiqui
authors.forename: Mary L
authors.initials: ML
authors.lastname: Wagner
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Hening
authors.forename: Daniel
authors.initials: D
authors.lastname: Lewin
authors.forename: Glenna
authors.initials: G
authors.lastname: Winnie
authors.forename: Barry
authors.initials: B
authors.lastname: Cohen
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Walters
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D015259:Dopamine Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D009483:Neuropsychological Tests; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D015990:Placebo Effect; D017286:Polysomnography; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D012890:Sleep / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D015259:Dopamine Agents; D007980:Levodopa