title: Restless legs syndrome outside the blood-brain barrier--exacerbation by domperidone in Parkinson's disease.
abstract: BACKGROUND
  Models of dopaminergic function in restless legs focus on central dopaminergic neurons. Domperidone, a peripheral dopamine blocker that cannot cross the blood-brain barrier, is commonly used in Parkinson's disease. After encountering a case of restless legs syndrome that dramatically worsened with domperidone, we assessed whether Parkinson's patients may have exacerbation of restless legs with domperidone.
  
  
  METHODS
  From two Parkinson's disease cohorts, we assessed restless legs prevalence according to standard criteria, in patients taking vs. not taking domperidone. Regression analysis was performed, adjusting for age, sex, disease duration, UPDRS, dopaminergic medications and other medications.
  
  
  RESULTS
  One hundred eighty four patients were assessed, of whom 46 (25%) had restless legs. Thirteen out of twenty seven (48%) patients on domperidone had restless legs compared to 33/157 (21%) without (p = 0.010). Other medications were not associated with restless legs.
  
  
  CONCLUSIONS
  This unexpected finding suggests that dopaminergic neurons outside of the blood-brain barrier may be important in restless legs syndrome pathophysiology.
authors.affiliation: Department of Neurology, McGill University, Montreal General Hospital, 1650 Cedar Ave., Montreal L 7-312, Quebec H3G1A4, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Rios Romenets
authors.forename: Y
authors.initials: Y
authors.lastname: Dauvilliers
authors.forename: V
authors.initials: V
authors.lastname: Cochen De Cock
authors.forename: B
authors.initials: B
authors.lastname: Carlander
authors.forename: S
authors.initials: S
authors.lastname: Bayard
authors.forename: C
authors.initials: C
authors.lastname: Galatas
authors.forename: C
authors.initials: C
authors.lastname: Wolfson
authors.forename: R B
authors.initials: RB
authors.lastname: Postuma
mesh_terms: D000368:Aged; D001812:Blood-Brain Barrier / Q000503:physiopathology*; D004294:Domperidone / Q000009:adverse effects* / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D015995:Prevalence; D012148:Restless Legs Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D018492:Dopamine Antagonists; D004294:Domperidone