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Rzepka M, Chmiela T, Kaczmarczyk A, Krzystanek E. Insomnia, Fatigue, Bladder Disorders and Mood Disorders among Polish Patients with Multiple Sclerosis: Cross-Sectional Study. J Clin Med 2024; 13:1043. [PMID: 38398356 PMCID: PMC10888699 DOI: 10.3390/jcm13041043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND To investigate the prevalence of sleep disorders in patients with multiple sclerosis (PwMS) in comparison to healthy controls (HCs), we aim to explore the correlation between sleep disorders and fatigue, bladder dysfunction, mood disorders in PwMS. METHODS This study involved 175 PwMS and 115 HCs. We conducted a self-administered survey using questionnaires (the authors' questionnaire, the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSS), the Hospital Anxiety and Depression Scale (HADS), and the Numerical Rating Scale (NRS). The neurological disability was determined using Expanded Disability Status Scale. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS According to AIS, insomnia was found in 20.6% of PwMS compared to 9.6% of HCs (p < 0.001). Comparing female and male PwMS, we observed that insomnia was more prevalent among female PwMS (25.95% vs. 4.55%, respectively, p < 0.05). Excessive daytime sleepiness was more prevalent in female PwMS (p < 0.05). Female PwMS were more fatigue based on the FSS and the MFIS (p < 0.05). Bladder disorders were observed in 39.43% of PwMS and were significantly linked to MS (p < 0.001). Sleep disturbances were associated with anxiety disorders (OR = 0.22, 95% CI 0.12-0.32 p < 0.001), bladder dysfunction (OR = 0.52 95% CI 0.16-0.87 p < 0.05), and female gender (OR = 0.49, 95% CI 0.037-0.94 p < 0.05). CONCLUSIONS Insomnia is prevalent among PwMS. Our study revealed independent predictors of sleep disturbances among PwMS: female gender, bladder disorders, and anxiety.
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Affiliation(s)
- Michalina Rzepka
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Tomasz Chmiela
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland;
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Pascazio A, Maestri M, Pasquali L, Hoxhaj D, Fabbrini M, Furfori G, Ulivi M, Bianchi F, Morganti R, Siciliano G, Bonanni E. Restless Legs Syndrome and fatigue in multiple sclerosis: A cross-sectional clinical study. Mult Scler Relat Disord 2023; 79:104946. [PMID: 37639779 DOI: 10.1016/j.msard.2023.104946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/05/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Restless Legs Syndrome is a sleep-related sensorimotor disorder with a higher prevalence in Multiple Sclerosis (MS) patients than in the general population. Our aim was to determine the prevalence of RLS in a group of relapsing-remittent multiple sclerosis (RRMS) patients, and to investigate whether RLS is associated with MS-related disability, sleep quality, mood disorders and fatigue. METHODS In this retrospective, mono-centric, observational study, 92 RRMS patients were recruited (median age 46.5 years, 68.5% female patients). Data on MS clinical and radiological variables were collected. Patients underwent a subjective evaluation with standardized questionnaires on sleep fatigue and mood, which were evaluated by an expert neurologists specialized in sleep disorders about the occurrence of RLS. RESULTS Prevalence of RLS in our sample was of 47.8%. Patients with RLS had a significantly higher rate of worse sleep quality and fatigue, compared to non RLS subjects (respectively 56.8% vs. 35.4%, p=0.04 and 54.4% vs 22.7%, p=0.002). Univariate analysis showed that RLS was significantly more frequent in fatigued patients (66.7% vs 38.5% RLS- patients, p=0.009). Multivariate analysis showed that fatigue correlated with MS-related disability (OR 1.556, p=0.011), poor sleep quality (OR 1.192, p 0.036), and mood disorders (OR 1.096, p 0.046). RLS appears to independently increase the risk of fatigue of 50%, without reaching clear statistical significance (OR 1.572, p 0,0079). CONCLUSION Our study confirms the high prevalence of RLS in patients with multiple sclerosis and highlights the potential impact of RLS on fatigue and its strict interaction with sleep quality.
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Affiliation(s)
- Alessia Pascazio
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy.
| | - Livia Pasquali
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Domeniko Hoxhaj
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Monica Fabbrini
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Giulia Furfori
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Martina Ulivi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Francesca Bianchi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, via Roma 67, Pisa 56126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
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Diaconu Ş, Irincu L, Ungureanu L, Ciopleiaș B, Țînț D, Falup-Pecurariu C. Restless Legs Syndrome in Parkinson's Disease. J Pers Med 2023; 13:915. [PMID: 37373904 DOI: 10.3390/jpm13060915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Restless legs syndrome (RLS) might worsen sleep quality and quality of life in people with Parkinson's disease (PwPD). OBJECTIVE The main aim of the present study is to explore the associations between RLS and sleep, quality of life and other non-motor symptoms (NMS) in a sample of PwPD. METHODS We compared the clinical features of 131 PwPD with and without RLS, in a cross-sectional study. We used several validated scales for assessment: the International Restless Legs Syndrome Study Group rating scale (IRLS), Parkinson's Disease Sleep Scale version 2 (PDSS-2), Parkinson's Disease Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQ) and International Parkinson and Movement Disorder Society Non-Motor Rating Scale (MDS-NMS). RESULTS Thirty-five patients (26.71%) out of the total PwPD met the RLS diagnostic criteria, without significant differences between male (57.14%) and female (42.87%) (p = 0.431). Higher total scores of PDSS-2 were recorded among PwPD + RLS (p < 0.001), suggesting worse sleep quality. Significant correlations were observed between the diagnosis of RLS and some types of pain (especially nocturnal pain), physical fatigue and probable sleep-disordered breathing, according to the MDS-NMSS assessment. CONCLUSIONS RLS has a high frequency in PwPD and it requires proper management, considering its consequences on sleep and quality of life.
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Affiliation(s)
- Ştefania Diaconu
- Department of Neurology, County Clinic Hospital, 500365 Braşov, Romania
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
| | - Laura Irincu
- Department of Neurology, County Clinic Hospital, 500365 Braşov, Romania
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
| | - Larisa Ungureanu
- Department of Neurology, County Clinic Hospital, 500365 Braşov, Romania
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
| | - Bogdan Ciopleiaș
- Department of Neurology, County Clinic Hospital, 500365 Braşov, Romania
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
| | - Diana Țînț
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
- Clinicco, 500059 Braşov, Romania
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, 500365 Braşov, Romania
- Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
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Heidbreder A, Trenkwalder C, Bachmann CG, Bartl M, Fulda S, Habersack L, Maihöfner C, Mathis J, Muntean L, Schneider B, Stefani A, Paulus J, Young P. Restless Legs Syndrom. SOMNOLOGIE 2023. [DOI: 10.1007/s11818-023-00399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Effect of exergaming in people with restless legs syndrome with multiple sclerosis: A single-blind randomized controlled trial. Mult Scler Relat Disord 2023; 70:104480. [PMID: 36603295 DOI: 10.1016/j.msard.2022.104480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation in the lower extremity, triggered by sitting and lying positions and release with motion. There is strong evidence that RLS prevalence is higher in persons with multiple sclerosis (MS, pwMS) than in the general population. Current literature has shown that exergaming as non-pharmacological therapy may be an effective method for symptoms such as balance, walking, fatigue, cognitive functions in pwMS, but the effects on RLS are not known. Therefore, the study's main aim is to investigate the effects of exergaming in pwMS with RLS. METHODS Thirty-one pwMS with RLS and 34 pwMS without RLS were randomly divided as exergaming group and control group. The outcome measures were International RLS Study Group Rating Scale, Modified Fatigue Impact Scale, MS Walking Scale, Timed 25-Foot Walk Test, Hospital Anxiety and Depression Scale, Godin-Shephard Leisure-Time Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, 6 min Walk Test, Timed and Up Go, MS International Quality of Life questionnaire, MS-Related Symptom Checklist. RESULTS 26 pwMS with RLS (11 exergaming group, 15 control group) and 27 pwMS without RLS (12 exergaming group, 15 control group) were included in 8-week post-treatment analyses. After an 8-week long-term follow-up, 16 pwMS with and without RLS completed the protocol. The RLS severity (p = 0.004), anxiety level (p = 0.024), sleep quality (0.005), walking (0.004), and balance functions (0.041) were improved in pwMS with RLS exergaming group, while RLS severity increased in control group (p = 0.004). At 8-week follow-up, the effect of exergaming on RLS severity, quality of life, sleep quality, and walking capacity was preserved. There was significant improvement in gait and balance functions in pwMS without RLS exergaming group, there was no significant differences control group. In 8-week follow-up, improvement obtained in pwMS without RLS exergaming group was not preserved. CONCLUSIONS This study suggests that exergaming training could be an effective method for managing RLS severity, anxiety, sleep quality, gait, balance, and quality of life in pwMS with RLS.
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Broström A, Alimoradi Z, Lind J, Ulander M, Lundin F, Pakpour A. Worldwide estimation of restless legs syndrome: a systematic review and meta-analysis of prevalence in the general adult population. J Sleep Res 2023; 32:e13783. [PMID: 36600470 DOI: 10.1111/jsr.13783] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 01/06/2023]
Abstract
This systematic review, meta-analysis and meta-regression assessed the prevalence of restless legs syndrome (RLS) in the general adult population. Studies identified in Scopus, PubMed, Web of Science, and PsycInfo between January 2000 and February 2022 were included if they used a case-control or cross-sectional design and reported data regarding the prevalence of RLS. The protocol was pre-registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022300709). A total of 97 studies including 483,079 participants from 33 different countries met the eligibility criteria. The Newcastle Ottawa Scale was used to evaluate the methodological quality, and the fill-and-trim method was used to correct probable publication bias, while the jack-knife method was performed to assess small study effect. The corrected overall pooled prevalence of RLS was 3% (95% confidence interval [CI] 1.4%-3.8%). The pooled prevalence of RLS syndrome was affected by methodological quality (no data from non-respondents in the included studies), gender (higher among women), study design (lower prevalence in case-control versus cohort and cross-sectional studies). The figures for corrected pooled prevalence among men, women, alcohol consumers and smokers were 2.8% (95% CI 2%-3.7%); 4.7% (95% CI 3.2%-6.3%); 1.4% (95% CI 0%-4.2%); and 2.7% (95% CI 0%-5.3%), respectively. The prevalence among male and female participants was lower in community-based versus non-community-based studies. Moreover, the prevalence was higher in developed versus developing countries and among elders versus adults. In conclusion, RLS is a common disorder in the general adult population, with a higher prevalence in women; however, prevalence data are affected by study design and quality.
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Affiliation(s)
- Anders Broström
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Zainab Alimoradi
- Social Determinants of Health Research Centre, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jonas Lind
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden.,Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | - Fredrik Lundin
- Department of Neurology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Amir Pakpour
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Kostenko EV. [The use of botulinum toxin type A in symptomatic therapy and medical rehabilitation of patients with multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:17-25. [PMID: 37966435 DOI: 10.17116/jnevro202312310117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The review of the current state of the problem of symptomatic therapy and medical rehabilitation (MR) of patients with multiple sclerosis (MS) is presented. The search was conducted in the databases Medline, Web of Science, PubMed and Scopus. Information is given about the most common symptoms of MS, among which sensory and motor disorders, bladder dysfunction, and pain have the greatest impact on the quality of life of patients, their functioning and independence in everyday life. The clinical characteristics of spasticity syndrome in MS and its relationship with quality of life indicators are considered. The features of the use of botulinum therapy (BT) in MS are considered. A high level of effectiveness of the use of BT in the treatment of neurogenic hyperactivity of detrusor and neurogenic bladder (the level of persuasiveness of recommendation A) and spasticity (the level of persuasiveness of recommendation B) is shown. Symptomatic treatment of MS and MR with the use of multidisciplinary programs helps to reduce disability, improve the quality of life of patients. When choosing symptomatic treatment and MR methods, it is customary to focus on the needs of patients.
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Affiliation(s)
- E V Kostenko
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Inflammatory factors and restless legs syndrome: A systematic review and meta-analysis. Sleep Med Rev 2022; 68:101744. [PMID: 36634410 DOI: 10.1016/j.smrv.2022.101744] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
The possible role of inflammatory factors in the pathogenesis of restless legs syndrome (RLS) is not well understood. Because several inflammatory diseases have shown an association with the risk for RLS, the measurement of serum/plasma levels of inflammatory factors has been a matter of a scarce number of studies. We performed a systematic review and a meta-analysis to assess the possible association of serum/plasma levels of inflammatory markers with the risk for RLS. Our results showed a significant trend towards higher serum/plasma C reactive protein (CRP) levels and higher neutrophil-to-lymphocyte (NLR) ratio in patients diagnosed with RLS than in controls, although statistical significance disappeared after applying the random-effects model. Further studies are needed to confirm the suggested possible role of inflammatory factors in the pathogenesis of RLS.
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Affiliation(s)
| | | | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Jiménez-Jiménez FJ, Gómez-Tabales J, Alonso-Navarro H, Rodríguez C, Turpín-Fenoll L, Millán-Pascual J, Álvarez I, Pastor P, Calleja M, García-Ruiz R, Navarro-Muñoz S, Recio-Bermejo M, Plaza-Nieto JF, García-Albea E, García-Martín E, Agúndez JAG. LAG3/CD4 Genes Variants and the Risk for Restless Legs Syndrome. Int J Mol Sci 2022; 23:ijms232314795. [PMID: 36499121 PMCID: PMC9739762 DOI: 10.3390/ijms232314795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
According to several studies, inflammatory factors could be related to the pathogenesis of idiopathic restless legs syndrome (RLS). In addition, RLS and Parkinson's disease (PD) have shown a possible relationship, and recent studies have shown an association between CD4 rs1922452 and CD4 rs951818 single nucleotide variants (SNVs) and the risk for PD. For these reasons, we investigated the possible association between common variants in the LAG3/CD4 genes (which encoded proteins involved in inflammatory and autoimmune responses) and the risk for RLS in a Caucasian Spanish population. We assessed the frequencies of CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 genotypes and allelic variants in 285 patients with idiopathic RLS and 350 healthy controls using a specific TaqMan-based qPCR assay. We also analyzed the possible influence of the genotypes' frequencies on several variables, including age at onset of RLS, gender, family history of RLS, and response to drugs commonly used in the treatment of RLS. We found a lack of association between the frequencies of genotypes and allelic variants of the 3 SNVs studied and the risk of RLS, and a weak though significant association between the CD4 rs1922452 GG genotype and an older age at onset of RLS. With the exception of this association, our findings suggest that common SNVs in the CD4/LAG3 genes are not associated with the risk of developing idiopathic RLS in Caucasian Spanish people.
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Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, E28500 Arganda del Rey, Spain
- Correspondence: or ; Tel.: +34-636-968-395
| | - Javier Gómez-Tabales
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | | | - Christopher Rodríguez
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | - Laura Turpín-Fenoll
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | - Jorge Millán-Pascual
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | - Ignacio Álvarez
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, E08221 Terrassa, Spain
- Movement Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, E08221 Terrassa, Spain
| | - Pau Pastor
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, E08221 Terrassa, Spain
- Movement Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, E08221 Terrassa, Spain
- Unit of Neurodegenerative Diseases, Department of Neurology, The Germans Trias i Pujol Research Institute (IGTP), University Hospital Germans Trias i Pujol, E08916 Badalona, Spain
| | - Marisol Calleja
- Section of Neurology, Hospital Universitario del Sureste, E28500 Arganda del Rey, Spain
| | - Rafael García-Ruiz
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | | | - Marta Recio-Bermejo
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | | | - Esteban García-Albea
- Department of Medicine-Neurology, Universidad de Alcalá, E28801 Alcalá de Henares, Spain
| | - Elena García-Martín
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | - José A. G. Agúndez
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
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Movement Disorders in Multiple Sclerosis: An Update. Tremor Other Hyperkinet Mov (N Y) 2022; 12:14. [PMID: 35601204 PMCID: PMC9075048 DOI: 10.5334/tohm.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Multiple sclerosis (MS), a subset of chronic primary inflammatory demyelinating disorders of the central nervous system, is closely associated with various movement disorders. These disorders may be due to MS pathophysiology or be coincidental. This review describes the full spectrum of movement disorders in MS with their possible mechanistic pathways and therapeutic modalities. Methods: The authors conducted a narrative literature review by searching for ‘multiple sclerosis’ and the specific movement disorder on PubMed until October 2021. Relevant articles were screened, selected, and included in the review according to groups of movement disorders. Results: The most prevalent movement disorders described in MS include restless leg syndrome, tremor, ataxia, parkinsonism, paroxysmal dyskinesias, chorea and ballism, facial myokymia, including hemifacial spasm and spastic paretic hemifacial contracture, tics, and tourettism. The anatomical basis of some of these disorders is poorly understood; however, the link between them and MS is supported by clinical and neuroimaging evidence. Treatment options are disorder-specific and often multidisciplinary, including pharmacological, surgical, and physical therapies. Discussion: Movements disorders in MS involve multiple pathophysiological processes and anatomical pathways. Since these disorders can be the presenting symptoms, they may aid in early diagnosis and managing the patient, including monitoring disease progression. Treatment of these disorders is a challenge. Further work needs to be done to understand the prevalence and the pathophysiological mechanisms responsible for movement disorders in MS.
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