1
|
Altamura C, Corbelli I, de Tommaso M, Di Lorenzo C, Di Lorenzo G, Di Renzo A, Filippi M, Jannini TB, Messina R, Parisi P, Parisi V, Pierelli F, Rainero I, Raucci U, Rubino E, Sarchielli P, Li L, Vernieri F, Vollono C, Coppola G. Pathophysiological Bases of Comorbidity in Migraine. Front Hum Neurosci 2021; 15:640574. [PMID: 33958992 PMCID: PMC8093831 DOI: 10.3389/fnhum.2021.640574] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Despite that it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bidirectional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involves a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.
Collapse
Affiliation(s)
- Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Ilenia Corbelli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Bari, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso B Jannini
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberta Messina
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,Headache Clinic, IRCCS-Neuromed, Pozzilli, Italy
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Linxin Li
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Catello Vollono
- Department of Neurology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| |
Collapse
|
2
|
Clemow DB, Baygani SK, Hauck PM, Hultman CB. Lasmiditan in patients with common migraine comorbidities: a post hoc efficacy and safety analysis of two phase 3 randomized clinical trials. Curr Med Res Opin 2020; 36:1791-1806. [PMID: 32783644 DOI: 10.1080/03007995.2020.1808780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT1F receptor agonist approved in the United States for the acute treatment of migraine. METHODS In SPARTAN and SAMURAI (double-blind Phase 3 clinical trials), patients with migraine were randomized to oral lasmiditan 50 mg (SPARTAN only), 100mg, 200 mg, or placebo. Lasmiditan increased the proportion of pain-free and most bothersome symptom (MBS)-free patients at 2 h after dose compared with placebo. Most common treatment-emergent adverse events (TEAEs) were dizziness, paraesthesia, somnolence, fatigue, nausea, muscular weakness, and hypoesthesia. Based upon literature review of common migraine comorbidities, Anxiety, Allergy, Bronchial, Cardiac, Depression, Fatigue, Gastrointestinal, Hormonal, Musculoskeletal/Pain, Neurological, Obesity, Sleep, and Vascular Comorbidity Groups were created. Using pooled results, efficacy and TEAEs were assessed to compare patients with or without a given common migraine comorbidity. To compare treatment groups, p-values were calculated for treatment-by-subgroup interaction, based on logistic regression with treatment-by-comorbidity condition status (Yes/No) as the interaction term; study, treatment group, and comorbidity condition status (Yes/No) were covariates. Differential treatment effect based upon comorbidity status was also examined. Trial registration at clinicaltrials.gov: SAMURAI (NCT02439320) and SPARTAN (NCT02605174). RESULTS Across all the Comorbidity Groups, with the potential exception of fatigue, treatment-by-subgroup interaction analyses did not provide evidence of a lasmiditan-driven lasmiditan versus placebo differential treatment effect dependent on Yes versus No comorbidity subgroup for either efficacy or TEAE assessments. CONCLUSIONS The efficacy and safety of lasmiditan for treatment of individual migraine attacks appear to be independent of comorbid conditions.
Collapse
Affiliation(s)
- David B Clemow
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Simin K Baygani
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Paula M Hauck
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Cory B Hultman
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| |
Collapse
|
3
|
Ghasemi H, Khaledi-Paveh B, Abdi A, Jalali R, Salari N, Vaisi-Raygani A, Mohammadi M. The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis. Pain Res Manag 2020; 2020:2763808. [PMID: 32908621 PMCID: PMC7475739 DOI: 10.1155/2020/2763808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/06/2020] [Accepted: 08/21/2020] [Indexed: 11/17/2022]
Abstract
Background Migraine is a severe and debilitating neurologic disorder and is claimed to be the sixth disabling illness in the world. This study aimed to determine the overall prevalence of restless legs syndrome (RLS) in patients with migraine through a systematic review and meta-analysis. Methods To identify and select related studies, the Scopus, ScienceDirect, Embase, SID, IranDoc, Web of Science, Knowledge Network System Medline (PubMed), and Google Scholar databases were searched. All related cross-sectional studies, published in English or Persian language between January 2000 and December 2019 and using the keywords such as migraine, restless leg syndrome, sleep disorder, RLS, and migraine disorder, were collected. The heterogeneity of the studies was assessed using the I 2 index, and the data analysis was performed using the Comprehensive Meta-Analysis software. Results Analysis was conducted on the reported results of the final 12 articles with the total sample size of 15196. The overall prevalence of RLS in patients with migraine was 16.3% (95% CI: 12.6-20.8%). The prevalence of RLS migraine patients decreased with increasing the sample size, and the prevalence of RLS migraine patients increased with increasing the research year, which was statistically significant (P < 0.05). Conclusion This study highlights that RLS is high in patients with migraine, and therefore, the clinicians should be aware of its incidence and take preventive measures.
Collapse
Affiliation(s)
- Hooman Ghasemi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aliakbar Vaisi-Raygani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
4
|
Wang J, Gao Y, Liu L, Xu W, Zhang P, Liu Y, Qian X, Yu S. The association between migraine and restless legs syndrome: an updated systematic review and meta-analysis. Sleep Med 2019; 57:21-29. [PMID: 30897452 DOI: 10.1016/j.sleep.2019.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/26/2018] [Accepted: 01/03/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aims to gain further insight into the association between migraine and restless legs syndrome (RLS). METHODS A literature search of PubMed, Embase, and Web of Science was performed for studies investigating the association between any migraine and RLS; a meta-analysis of eligible studies was conducted to determine a pooled effect estimate for the association. RESULTS Fifteen studies were included in this meta-analysis. The studies differed in methodology, but all investigated the association between migraine and RLS. Pooled RLS prevalence was 17.0% [95% confidence interval (CI) 15.0%-20.0%] among migraineurs, and 7.0% (95% CI 5.0%-8.0%) among no migraine individuals. Pooled analyses showed that migraine was associated with RLS, but effect estimates were substantially higher in case-control studies [pooled odds ratio (OR) = 3.77, 95% CI 2.73-5.21; I2 = 50.1%] than in cross-sectional studies (pooled OR = 1.25, 95% CI 1.11-1.41; I2 = 34.2%). Subgroup analyses were not conducted to find potential factors that affect this association because of too few available studies. CONCLUSIONS This updated meta-analysis confirms the association between migraine and RLS. Future studies should specifically investigate the potential effects of gender, age, aura status, and type (episodic or chronic) of migraine on the association between the two disorders.
Collapse
Affiliation(s)
- Jing Wang
- School of Medicine, Nankai University, Tianjin, 300071, China; Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yinghui Gao
- Peking University People's Hospital, Beijing, 100044, China; Peking University Hepatology Institute, Beijing, 100044, China; Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, 100044, China
| | - Lin Liu
- Department of Respiratory Disease, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China
| | - Weihao Xu
- Department of Geriatric Cardiology, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China
| | - Peicheng Zhang
- Department of Retired Cadre, No. 51 Division, Beijing Military Command, Beijing, China
| | - Yu Liu
- Department of Retired Cadre, No. 51 Division, Beijing Military Command, Beijing, China
| | - Xiaoshun Qian
- Department of Respiratory Disease, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Shengyuan Yu
- School of Medicine, Nankai University, Tianjin, 300071, China; Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|
5
|
Yang FC, Chou KH, Lee PL, Yin JH, Chen SY, Kao HW, Sung YF, Chou CH, Tsai CK, Tsai CL, Lin CP, Lee JT. Patterns of gray matter alterations in migraine and restless legs syndrome. Ann Clin Transl Neurol 2018; 6:57-67. [PMID: 30656184 PMCID: PMC6331309 DOI: 10.1002/acn3.680] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/29/2018] [Accepted: 10/01/2018] [Indexed: 01/18/2023] Open
Abstract
Objectives Migraine and restless legs syndrome (RLS) are often comorbid and share elements of pathology; however, their neuroanatomical underpinnings are poorly understood. This study aimed to identify patterns of gray matter volume (GMV) alteration specific to and common among patients with RLS, migraine, and comorbid migraine and RLS. Methods High‐resolution T1‐weighted images were acquired from 116 subjects: 27 RLS patients, 22 migraine patients, 22 patients with comorbid migraine and RLS, and 45 healthy controls. Direct group comparisons and conjunction analysis were first used to localize the distinct and shared neural signatures of migraine and RLS. We also investigated whether the shared neural signature could be replicated in an additional comorbid migraine/RLS group. Results Compared with healthy controls, migraine patients showed GMV changes in the lateral occipital cortex, cerebellum, frontal pole, and middle frontal gyrus (MFG), and RLS patients showed GMV changes in the thalamus, middle temporal gyrus, anterior cingulate cortex, insular cortex, and MFG. In migraine, compared with RLS, GMV differences were found in the precuneus, lateral occipital and occipital fusiform cortex, superior frontal and precentral gyri, and cerebellum. Conjunction analyses for these disorders showed altered GMV in the MFG, also found in patients with comorbid migraine and RLS. The GMV of the MFG also correlated with sleep quality in patients with comorbid migraine and RLS. Interpretation Migraine and RLS are characterized by shared and distinctive neuroanatomical characteristics, with a specific role of the MFG. These findings may be related to shared pathophysiology of these two distinct disorders.
Collapse
Affiliation(s)
- Fu-Chi Yang
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan
| | - Kun-Hsien Chou
- Brain Research Center National Yang-Ming University Taipei Taiwan.,Institute of Neuroscience National Yang-Ming University Taipei Taiwan
| | - Pei-Lin Lee
- Department of Biomedical Imaging and Radiological Sciences National Yang-Ming University Taipei Taiwan
| | - Jiu-Haw Yin
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan.,Division of Neurology Department of Medicine Cheng Hsin General Hospital Taipei Taiwan
| | - Shao-Yuan Chen
- Department of Neurology Cardinal Tien Hospital New Taipei City Taiwan.,Department of Hyperbaric Medicine Cardinal Tien Hospital New Taipei City Taiwan.,School of Medicine Fu-Jen Catholic University New Taipei City Taiwan
| | - Hung-Wen Kao
- Department of Radiology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan
| | - Yueh-Feng Sung
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan
| | - Chung-Hsing Chou
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan.,Graduate Institute of Medical Sciences National Defense Medical Center Taipei Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan
| | - Chia-Lin Tsai
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan
| | - Ching-Po Lin
- Brain Research Center National Yang-Ming University Taipei Taiwan.,Institute of Neuroscience National Yang-Ming University Taipei Taiwan.,Department of Biomedical Imaging and Radiological Sciences National Yang-Ming University Taipei Taiwan.,Institute of Brain Science National Yang-Ming University Taipei Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology Tri-Service General Hospital National Defense Medical Center Taipei Taiwan.,Graduate Institute of Medical Sciences National Defense Medical Center Taipei Taiwan
| |
Collapse
|
6
|
Suzuki K, Suzuki S, Haruyama Y, Kobashi G, Shiina T, Hirata K. Restless legs syndrome is associated with headache-related disabilities in patients with migraine: a prospective 7-year follow-up study. Eur J Neurol 2018; 26:238-245. [PMID: 30169898 DOI: 10.1111/ene.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/28/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE No prospective study has evaluated the impact of restless legs syndrome (RLS) on clinical factors in patients with migraine. We planned a prospective study to assess the impact of RLS comorbid status on clinical factors in patients with migraine. METHODS A total of 101 patients with migraine who were evaluated for RLS twice at 7-year intervals in a university hospital setting were included in this study. The RLS group was defined as positive for RLS at either baseline or follow-up and the non-RLS group was defined as negative for RLS at both baseline and follow-up. The Migraine Disability Assessment (MIDAS) questionnaire, Beck Depression Inventory-II (BDI-II), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale were administered to all patients. RESULTS The RLS prevalence was 16.8% at baseline and 20.8% at follow-up. Compared with the non-RLS group (n = 27), the RLS group (n = 74) showed a significantly higher rate of smoking and higher MIDAS and BDI-II scores at 7-year follow-up. A significant reduction in MIDAS and BDI-II scores at 7-year follow-up compared with those at baseline was observed in the non-RLS group, but not in the RLS group. The non-RLS group showed a significantly lower MIDAS score at 7-year follow-up than the RLS group after adjusting for confounding variables such as age, gender, smoking status, Epworth Sleepiness Scale and PSQI scores using analysis of covariance. The persistent RLS group (n = 11) (positive for RLS at both baseline and follow-up) showed a significantly higher rate of smoking and increased MIDAS, BDI-II and PSQI scores compared with the non-RLS group (n = 74) at 7-year follow-up. CONCLUSION Our prospective study showed that RLS had a significant impact on headache-related disability in patients with migraine.
Collapse
Affiliation(s)
- K Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - S Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Y Haruyama
- Department of Public Health School of Medicine, Dokkyo Medical University, Tochigi, Japan
| | - G Kobashi
- Department of Public Health School of Medicine, Dokkyo Medical University, Tochigi, Japan
| | - T Shiina
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - K Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| |
Collapse
|
7
|
Vgontzas A, Pavlović JM. Sleep Disorders and Migraine: Review of Literature and Potential Pathophysiology Mechanisms. Headache 2018; 58:1030-1039. [PMID: 30091160 DOI: 10.1111/head.13358] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/20/2022]
Abstract
Migraine shares a complex and poorly understood relationship with sleep. Patients consistently report poor sleep prior to migraine attacks and during them, identifying poor sleep as a migraine trigger. However, anecdotally, sleep is reported to serve a therapeutic role in terminating headache. Are the associations between migraine and sleep simply the result of various bidirectional relationships? A growing body of evidence suggests there may be a common underlying etiology as well. Our objective was to review studies of sleep and migraine from the last 2 decades utilizing validated subjective and objective measures of sleep and to explore potential mechanisms underlying this complex relationship by incorporating recent advances in neuroscience. We specifically focus on insomnia, obstructive sleep apnea, parasomnias, sleep related movement disorders, and REM sleep related disorders and their relationship to migraine. Parts of brainstem-cortical networks involved in sleep physiology are unintentionally being identified as important factors in the common migraine pathway. Recent discoveries on anatomic localization (the hypothalamus as a key and early mediator in the pathophysiology of migraine), common mediating signaling molecules (such as serotonin and dopamine), and the discovery of a new CNS waste removal system, the glymphatic system, all point to a common pathophysiology manifesting in migraine and sleep problems.
Collapse
Affiliation(s)
- Angeliki Vgontzas
- John R. Graham Headache Center, Department of Neurology, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, MA, USA
| | - Jelena M Pavlović
- Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
8
|
Bollu PC, Yelam A, Thakkar MM. Sleep Medicine: Restless Legs Syndrome. MISSOURI MEDICINE 2018; 115:380-387. [PMID: 30228773 PMCID: PMC6140269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Restless Legs Syndrome is a highly prevalent sensorimotor disorder characterized by urge to move the legs due to discomfort that primarily happens in the evening or at nights. Although the exact pathophysiology remains unclear, brain iron deficiency and altered dopaminergic function appears to play an important role in the pathogenesis of this condition. This disorder affects women more frequently and is associated with significant morbidity.
Collapse
Affiliation(s)
- Pradeep C Bollu
- Pradeep C. Bollu, MD, Anudeep Yelam, MD and Mahesh Thakkar, PhD are in the Department of Neurology, University of Missouri-Columbia
| | - Anudeep Yelam
- Pradeep C. Bollu, MD, Anudeep Yelam, MD and Mahesh Thakkar, PhD are in the Department of Neurology, University of Missouri-Columbia
| | - Mahesh M Thakkar
- Pradeep C. Bollu, MD, Anudeep Yelam, MD and Mahesh Thakkar, PhD are in the Department of Neurology, University of Missouri-Columbia
| |
Collapse
|
9
|
Didriksen M, Hansen TF, Thørner LW, Burgdorf KS, Erikstrup C, Pedersen OB, Paarup HM, Nielsen KR, Hjalgrim H, Sørensen E, Ullum H. Restless legs syndrome is associated with increased risk of migraine. CEPHALALGIA REPORTS 2018. [DOI: 10.1177/2515816318780743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Migraine and restless legs syndrome (RLS) are common disorders that are associated with a high level of individual suffering and major comorbidities. The aetiologies of the disorders are largely unknown, although both migraine and RLS have been linked to disturbances in the dopaminergic system and sleep issues, suggesting a relationship between the disorders. This study examines the association between RLS and migraine in a large population of otherwise healthy adults who are not taking medication. Cross-sectional study that included 20,938 participants enrolled in the Danish Blood Donor Study from 1 May 2015 to 1 February 2017. The study included complete information on migraines, the Cambridge-Hopkins RLS questionnaire, the Major Depression Inventory Scale, sex, age, body mass index (BMI), educational level, smoking status and alcohol consumption. Associations between RLS and migraine, with and without aura, were examined using multivariable logistic regression analysis. Among the participants, 4827 were self-reported migraine sufferers and 1091 were classified as suffering from RLS. Individuals with RLS had an increased risk of migraine compared to non-RLS sufferers, with an odds ratio (OR) = 1.52 (95% confidence interval: 1.33–1.73). For the investigated subtypes of migraine, this association was found to be OR = 1.55 (1.31–1.83) for migraines with aura and OR = 1.29 (1.09–1.52) for migraines without aura. We found a significantly increased occurrence of migraine in individuals with RLS. This risk was independent of sex, age, BMI, educational level, smoking status, alcohol consumption and depressive disorder. Our findings suggest that RLS and migraine may have a common aetiology.
Collapse
Affiliation(s)
- Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas F Hansen
- Department of Neurology, Danish Headache Center, Glostrup Research Institute, Copenhagen University Hospital Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Lise W Thørner
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kristoffer S Burgdorf
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Helene M Paarup
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
10
|
Abstract
Migraine is one of the most common neurological disorders. In addition to severe headaches, non-headache symptoms associated with migraine attacks as well as co-morbid disorders frequently aggravate the disabling of migraine patients. Some of these symptoms are related to poor outcomes. In this review, we update the advances of studies on certain non-headache symptoms, including visual disturbance, gastrointestinal symptoms, allodynia, vestibular symptoms, and symptoms of co-morbid restless legs syndrome and psychiatric disorders.
Collapse
Affiliation(s)
- Ping-Kun Chen
- School of Medicine, China Medical University, Taichung, Taiwan.,Bo-Zhi Neurology Clinic, Taichung, Taiwan.,Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Shuu-Jiun Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
11
|
Yang FC, Chou KH, Hsu AL, Fuh JL, Lirng JF, Kao HW, Lin CP, Wang SJ. Altered Brain Functional Connectome in Migraine with and without Restless Legs Syndrome: A Resting-State Functional MRI Study. Front Neurol 2018; 9:25. [PMID: 29441041 PMCID: PMC5797592 DOI: 10.3389/fneur.2018.00025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/12/2018] [Indexed: 01/03/2023] Open
Abstract
Background Migraine is frequently comorbid with restless legs syndrome (RLS), both displaying functional connectivity (FC) alterations in multiple brain networks, although the neurological basis of this association is unknown. Methods We performed resting-state functional magnetic resonance imaging and network-wise analysis of FC in migraine patients with and without RLS and healthy controls (CRL). Network-based statistics (NBS) and composite FC matrix analyses were performed to identify the patterns of FC changes. Correlation analyses were performed to identify associations between alterations in FC and clinical profiles. Results NBS results revealed that both migraine patients with and without RLS exhibited lower FC than CRL in the dorsal attention, salience, default mode, cingulo-opercular, visual, frontoparietal, auditory, and sensory/somatomotor networks. Further composite FC matrix analyses revealed differences in FC of the salience, default mode to subcortical and frontoparietal, auditory to salience, and memory retrieval networks between migraine patients with and without RLS. There was a trend toward a negative association between RLS severity and cross-network abnormalities in the default mode to subcortical network. Discussion Migraine patients with and without RLS exhibit disruptions of brain FC. Such findings suggest that these disorders are associated with differential neuropathological mechanisms and may aid in the future development of neuroimaging-driven biomarkers for these conditions.
Collapse
Affiliation(s)
- Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Ai-Ling Hsu
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jiing-Feng Lirng
- Department of Radiology, National Yang-Ming University, Taipei, Taiwan.,Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Wen Kao
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
12
|
Valente M, Janes F, Russo V, Fontana A, Travanut A, Sommaro M, Canal G, Gentile C, Luigi Gigli G. Prevalence of Restless Legs Syndrome in Migraine Patients: A Case-Control Study. Analysis of Risk Factors for Restless Legs Syndrome in Migraine Patients. Headache 2017; 57:1088-1095. [PMID: 28699332 DOI: 10.1111/head.13124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 04/10/2017] [Accepted: 04/25/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a sensorimotor disorder. It can be idiopathic, associated to other diseases or to pharmacologic treatments. RLS has been reported to occur more frequently in migraine patients, but a clear pathogenetic link seems still under debate. We aimed to evaluate RLS prevalence in migraine, impact on sleep quality and the main clinical determinants of this association. METHODS Migraine patients and age- and sex-matched controls were enrolled from 1st January 2011 to 30th December 2012. Migraine and RLS diagnosis complied with already published clinical criteria. Medical and pharmacological histories, as well as structured questionnaires were collected. RESULTS RLS was found in 29/180 (16.1%) patients and 11/180 (6.1%) controls. The odds ratio (OR) for RLS was 2.95 (CI 95%, 1.42-6.11). Among migraine patients, after adjustment for possible confounding factors, familial history (OR 3.863, CI 1.076-13.873), and serotoninergic overload (OR 3.654, CI 1.347-9.916) were significantly associated with RLS occurrence. Pittsburgh Sleep Quality Index score was higher in migraine patients with RLS than in subjects without RLS. CONCLUSIONS The confirmed association between migraine and RLS might be because of familial predisposition and to serotoninergic drugs effect, possibly interfering with the balance between dopaminergic and serotoninergic pathways.
Collapse
Affiliation(s)
- Mariarosaria Valente
- Department of Neuroscience, S. Maria della Misericordia University Hospital, Udine, Italy.,Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Francesco Janes
- Department of Neuroscience, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Valentina Russo
- Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Augusto Fontana
- Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Alessia Travanut
- Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Martina Sommaro
- Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Giessica Canal
- Department of Neuroscience, S. Maria della Misericordia University Hospital, Udine, Italy.,Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Carolina Gentile
- Department of Neuroscience, S. Maria della Misericordia University Hospital, Udine, Italy.,Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| | - Gian Luigi Gigli
- Department of Neuroscience, S. Maria della Misericordia University Hospital, Udine, Italy.,Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy
| |
Collapse
|
13
|
Lin GY, Lin YK, Lee JT, Lee MS, Lin CC, Tsai CK, Ting CH, Yang FC. Prevalence of restless legs syndrome in migraine patients with and without aura: a cross-sectional, case-controlled study. J Headache Pain 2016; 17:97. [PMID: 27770406 PMCID: PMC5074935 DOI: 10.1186/s10194-016-0691-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/15/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the comorbidity of migraine and restless legs syndrome (RLS) has been well-documented, the association between RLS and migraine frequency has yet to be elucidated. The present study aims to evaluate the prevalence of RLS among individuals who experience low-frequency, high-frequency, or chronic migraine presenting with and without aura. METHODS We conducted a cross-sectional, case-controlled study involving 505 participants receiving outpatient headache treatment. Standardized questionnaires were administered to collect information on experiences of migraine, RLS, sleep quality, anxiety, depression, and demographics. Participants were categorized into low-frequency (1-8/month), high-frequency (9-14/month), and chronic (≥15/month) headache groups. RLS was diagnosed according to the criteria outlined by the International RLS Study Group (IRLSSG). The Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality and identify symptoms of anxiety and depression. Associations between migraine frequency and RLS prevalence were investigated using multivariate linear and logistic regression. RESULTS Univariate analysis revealed an effect of migraine frequency on RLS prevalence (p = 0.026), though this effect did not persist following adjustment for baseline characteristics (p = 0.256). The trend was robust in patients whose migraines presented with auras (p univariate = 0.002; p multivariate = 0.043) but not in those without auras (p univariate and p multivariate > 0.05). Higher anxiety [odds ratio (OR) = 1.18, p = 0.019] and sleep disturbance (OR = 1.17, p = 0.023) scores were associated with higher RLS prevalence. CONCLUSIONS Higher migraine frequency correlates with a higher prevalence of RLS, particularly among patients with auras.
Collapse
Affiliation(s)
- Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsin Ting
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| |
Collapse
|
14
|
Acar BA, Acar T, Alagöz AN, Karacan A, Varım C, Uyanık MŞ, Kaya T, Akdemir R. Relationship between primary restless legs syndrome and migraine with aura. Kaohsiung J Med Sci 2016; 32:420-6. [PMID: 27523456 DOI: 10.1016/j.kjms.2016.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/25/2022] Open
Abstract
In this study, the prevalence and characteristics of definite migraine in primary restless legs syndrome (pRLS) patients and matched control patients (CPs) were investigated. We evaluated 63 consecutive adult pRLS patients and 141 age- and sex-matched controls in this case-control study. The diagnosis of migraine and its subtypes were defined based on The International Classification of Headache Disorders-II. Only those with "definite" migraine were included in the study. The mean age of 63 adult pRLS patients (15 men and 48 women) who participated in the study was 49.4 years. A total of 27 patients (42.9%) had definite migraine. Of these migraineurs, seven (11.1%) were without aura and 20 (31.8%) were with aura. The mean age of the 141 matched CPs was 48.7 years. A total of 32 CPs (22.7%) experienced migraine. Among these 32 migraineurs, 28 (19.9%) were without aura and four (2.8%) were with aura. Migraine and migraine with aura were significantly more common in pRLS patients than in CPs. pRLS patients with migraine were more anxious and experienced a shorter duration of RLS symptoms than pRLS patients without migraine. Migraineurs in the pRLS group tended to have high scores for severity of migraine headache by Visual Analog Scale score and high levels of disability by Migraine Disability Assessment grading than those in the control group. pRLS patients showed a positive association with definite migraine headaches. In contrast to results highlighted in recent studies, we found a strong link between migraine with aura and pRLS.
Collapse
Affiliation(s)
| | - Türkan Acar
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | | | - Alper Karacan
- Department of Radiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Ceyhun Varım
- Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Mehmet Şevki Uyanık
- Department of Internal Medicine, Division of Hematology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Tezcan Kaya
- Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| |
Collapse
|
15
|
Kim J, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study. J Headache Pain 2016; 17:62. [PMID: 27363413 PMCID: PMC4929100 DOI: 10.1186/s10194-016-0655-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have shown that migraine and sleep disturbances are closely associated. Excessive daytime sleepiness (EDS) is a common symptom of various types of sleep disturbance. Findings from clinic-based studies suggest that a high percentage of migraineurs experience EDS. However, the prevalence and clinical impact of EDS among migraineurs at the population level have rarely been reported. The objective of this study was to investigate the prevalence and impact of EDS among migraineurs using a population-based sample in Korea. Methods We selected a stratified random sample of Koreans aged 19 to 69 years and evaluated them using a semi-structured interview designed to identify EDS, headache type, and the clinical characteristics of migraine. If the score on the Epworth Sleepiness Scale (ESS) was more than or equal to 11, the participant was classified as having EDS. Results Of the 2,695 participants that completed the interview, 143 (5.3 %) and 313 (11.6 %) were classified as having migraine and EDS, respectively. The prevalence of EDS was significantly higher in participants with migraine (19.6 %) and non-migraine headache (13.4 %) compared to non-headache controls (9.4 %). Migraineurs with EDS had higher scores on the Visual Analogue Scale (VAS) for headache intensity (6.9 ± 1.8 vs. 6.0 ± 1.9, p = 0.014) and Headache Impact Test-6 (59.8 ± 10.2 vs. 52.5 ± 8.2, p < 0.001) compared to migraineurs without EDS. Conclusions Approximately 20 % of migraineurs had EDS in this population-based sample. Excessive daytime sleepiness was associated with an exacerbation of some migraine symptoms.
Collapse
Affiliation(s)
- Jiyoung Kim
- Department of Neurology, Bio Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
| | - Chang-Ho Yun
- Clinical Neuroscience Center, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Min Kyung Chu
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, South Korea.
| |
Collapse
|
16
|
Chasman DI, Schürks M, Kurth T. Population-based approaches to genetics of migraine. Cephalalgia 2016; 36:692-703. [PMID: 27013237 DOI: 10.1177/0333102416638519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 02/06/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND While the most accurate diagnosis of migraine typically requires a clinical interview guided by strict diagnostic criteria, an alternative approach that ascertains migraine by questionnaire in population-based settings has been instrumental in the discovery of common genetic variants influencing migraine risk. This result may be surprising. Population-based approaches are often criticized for limited ability to distinguish migraine from other forms of primary headache. It is thus useful to revisit prevailing ideas about population-based ascertainment of migraine to evaluate the extent to which this approach has potential for additional insights into migraine genetics and therefore pathophysiology. OVERVIEW We review recent findings suggesting that the success of the population-based approach is derived from the possibility of collecting much larger samples than in the clinic-based setting even at the risk of introducing phenotypic and genetic heterogeneity. The findings are also consistent with new appreciations for the genetic basis of many other common, complex clinical characteristics. However, clinic-based ascertainment and other settings will remain more effective than population-based approaches for investigating certain, often very specific aspects of migraine genetics. CONCLUSION We argue that the detailed genetic architecture of migraine, various aspects of methodology, and the ultimate sample size achieved by population-based ascertainment will be critical determinants of the future success of this approach to genetic analysis of migraine and its comorbidities.
Collapse
Affiliation(s)
- Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, USA Harvard Medical School, USA
| | - Markus Schürks
- Department of Neurology, University Hospital Essen, Germany
| | - Tobias Kurth
- Division of Preventive Medicine, Brigham and Women's Hospital, USA Institut of Public Health, Charité-Universitätsmedizin Berlin, Germany
| |
Collapse
|
17
|
van Oosterhout WPJ, van Someren EJW, Louter MA, Schoonman GG, Lammers GJ, Rijsman RM, Ferrari MD, Terwindt GM. Restless legs syndrome in migraine patients: prevalence and severity. Eur J Neurol 2016; 23:1110-6. [PMID: 26998996 DOI: 10.1111/ene.12993] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/02/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Our aim was to study not only the prevalence but more importantly the severity and the correlation between sleep quality and restless legs syndrome (RLS) in a large population of well-defined migraine patients as poor sleep presumably triggers migraine attacks. METHODS In a large cross-sectional and observational study, data on migraine and RLS were collected from 2385 migraine patients (according to the International Classification of Headache Disorders ICHD-IIIb) and 332 non-headache controls. RLS severity (International RLS Study Group severity scale) and sleep quality (Pittsburgh Sleep Quality Index) were assessed. Risk factors for RLS and RLS severity were calculated using multivariable-adjusted regression models. RESULTS Restless legs syndrome prevalence in migraine was higher than in controls (16.9% vs. 8.7%; multivariable-adjusted odds ratio 1.83; 95% confidence interval 1.18-2.86; P = 0.008) and more severe (adjusted severity score 14.5 ± 0.5 vs. 12.0 ± 1.1; P = 0.036). Poor sleepers were overrepresented amongst migraineurs (50.1% vs. 25.6%; P < 0.001). Poorer sleep quality was independently associated with RLS occurrence (odds ratio 1.08; P < 0.001) and RLS severity (P < 0.001) in migraine patients. CONCLUSION Restless legs syndrome is not only twice as prevalent but also more severe in migraine patients, and associated with decreased sleep quality.
Collapse
Affiliation(s)
- W P J van Oosterhout
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E J W van Someren
- The Netherlands Institute of Neuroscience, Amsterdam, The Netherlands.,Departments of Integrative Neurophysiology and Medical Psychology, Centre for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Centre, Amsterdam, The Netherlands
| | - M A Louter
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Departments of Neurology and Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - G G Schoonman
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Elisabeth-Tweesteden Hospital Tilburg, Tilburg, The Netherlands
| | - G J Lammers
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Sleep Wake Centre SEIN Heemstede, Heemstede, The Netherlands
| | - R M Rijsman
- Centre for Sleep and Wake Disorders, Medical Centre Haaglanden, The Hague, The Netherlands
| | - M D Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - G M Terwindt
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
18
|
Trenkwalder C, Allen R, Högl B, Paulus W, Winkelmann J. Restless legs syndrome associated with major diseases: A systematic review and new concept. Neurology 2016; 86:1336-1343. [PMID: 26944272 DOI: 10.1212/wnl.0000000000002542] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/10/2015] [Indexed: 12/21/2022] Open
Abstract
Recent publications on both the genetics and environmental factors of restless legs syndrome (RLS) defined as a clinical disorder suggest that overlapping genetic risk factors may play a role in primary (idiopathic) and secondary (symptomatic) RLS. Following a systematic literature search of RLS associated with comorbidities, we identified an increased prevalence of RLS only in iron deficiency and kidney disease. In cardiovascular disease, arterial hypertension, diabetes, migraine, and Parkinson disease, the methodology of studies was poor, but an association might be possible. There is insufficient evidence for conditions such as anemia (without iron deficiency), chronic obstructive pulmonary disease, multiple sclerosis, headache, stroke, narcolepsy, and ataxias. Based on possible gene-microenvironmental interaction, the classifications primary and secondary RLS may suggest an inappropriate causal relation. We recognize that in some conditions, treatment of the underlying disease should be achieved as far as possible to reduce or eliminate RLS symptoms. RLS might be seen as a continuous spectrum with a major genetic contribution at one end and a major environmental or comorbid disease contribution at the other.
Collapse
Affiliation(s)
- Claudia Trenkwalder
- From Center of Parkinsonism and Movement Disorders (C.T.), Paracelsus-Elena Hospital, Kassel; Departments of Neurosurgery (C.T.) and Clinical Neurophysiology (W.P.), University Medical Center, Göttingen, Germany; Department of Neurology (R.A.), The Johns Hopkins Bayview Medical Center, Baltimore, MD; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Institute for Neurogenomic (J.W.), Helmholtz Zentrum München, Neuherberg; Neurologische Klinik und Poliklinik (J.W.), Klinikum rechts der Isar, Technische Universität München, Munich; and Munich Cluster for Systems Neurology (SyNergy) (J.W.), Munich, Germany.
| | - Richard Allen
- From Center of Parkinsonism and Movement Disorders (C.T.), Paracelsus-Elena Hospital, Kassel; Departments of Neurosurgery (C.T.) and Clinical Neurophysiology (W.P.), University Medical Center, Göttingen, Germany; Department of Neurology (R.A.), The Johns Hopkins Bayview Medical Center, Baltimore, MD; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Institute for Neurogenomic (J.W.), Helmholtz Zentrum München, Neuherberg; Neurologische Klinik und Poliklinik (J.W.), Klinikum rechts der Isar, Technische Universität München, Munich; and Munich Cluster for Systems Neurology (SyNergy) (J.W.), Munich, Germany
| | - Birgit Högl
- From Center of Parkinsonism and Movement Disorders (C.T.), Paracelsus-Elena Hospital, Kassel; Departments of Neurosurgery (C.T.) and Clinical Neurophysiology (W.P.), University Medical Center, Göttingen, Germany; Department of Neurology (R.A.), The Johns Hopkins Bayview Medical Center, Baltimore, MD; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Institute for Neurogenomic (J.W.), Helmholtz Zentrum München, Neuherberg; Neurologische Klinik und Poliklinik (J.W.), Klinikum rechts der Isar, Technische Universität München, Munich; and Munich Cluster for Systems Neurology (SyNergy) (J.W.), Munich, Germany
| | - Walter Paulus
- From Center of Parkinsonism and Movement Disorders (C.T.), Paracelsus-Elena Hospital, Kassel; Departments of Neurosurgery (C.T.) and Clinical Neurophysiology (W.P.), University Medical Center, Göttingen, Germany; Department of Neurology (R.A.), The Johns Hopkins Bayview Medical Center, Baltimore, MD; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Institute for Neurogenomic (J.W.), Helmholtz Zentrum München, Neuherberg; Neurologische Klinik und Poliklinik (J.W.), Klinikum rechts der Isar, Technische Universität München, Munich; and Munich Cluster for Systems Neurology (SyNergy) (J.W.), Munich, Germany
| | - Juliane Winkelmann
- From Center of Parkinsonism and Movement Disorders (C.T.), Paracelsus-Elena Hospital, Kassel; Departments of Neurosurgery (C.T.) and Clinical Neurophysiology (W.P.), University Medical Center, Göttingen, Germany; Department of Neurology (R.A.), The Johns Hopkins Bayview Medical Center, Baltimore, MD; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Institute for Neurogenomic (J.W.), Helmholtz Zentrum München, Neuherberg; Neurologische Klinik und Poliklinik (J.W.), Klinikum rechts der Isar, Technische Universität München, Munich; and Munich Cluster for Systems Neurology (SyNergy) (J.W.), Munich, Germany.
| |
Collapse
|
19
|
Yang FC, Lin TY, Chen HJ, Lee JT, Lin CC, Huang WY, Chen HH, Kao CH. Increased Risk of Restless Legs Syndrome in Patients With Migraine: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2016; 95:e2646. [PMID: 26844484 PMCID: PMC4748901 DOI: 10.1097/md.0000000000002646] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Previous studies suggest that an association between restless legs syndrome (RLS) and migraine exists. However, population-based data are unavailable in Asian cohorts. Our study thus aims to evaluate the association between migraine and RLS in a nationwide, population-based cohort in Taiwan and to examine the effects of age, sex, migraine subtype, and comorbidities on RLS development.Data from the Taiwan National Health Insurance Research Database were used. Patients aged 20 years or older with newly diagnosed migraine from 2000 to 2008 were included; 23,641 patients with newly diagnosed migraine and 94,564 subjects without migraine were randomly selected and followed until RLS development, withdrawal from the National Health Insurance, or until the end of 2011. A multivariate Cox proportional hazards regression model was used to explore the risk of RLS in patients with migraine after adjustment for demographic characteristics and comorbidities.Both cohorts were followed for a mean of 7.38 years. After adjustment for covariates, the risk of RLS was 1.42-fold higher (95% confidence interval = 1.13-1.79) in the migraine cohort than in the nonmigraine cohort (7.19 versus 3.42 years per 10,000 person-years). The increased risk was more prominent in males in the migraine cohort (1.87-fold increased risk, 95% confidence interval 1.22-2.85). Neither comorbidity status nor migraine subtype influenced the RLS risk.This population-based study demonstrated that migraine is associated with an increased risk of RLS compared with those without migraine, particularly in male patients with migraine and regardless of the comorbidity status.
Collapse
Affiliation(s)
- Fu-Chi Yang
- From the Department of Neurology (F-CY, J-TL, C-CL); Department of Internal Medicine, Division of Infectious Diseases and Tropical Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan (T-YL); Management Office for Health Data, China Medical University Hospital (H-JC); College of Medicine, China Medical University, Taichung (H-JC); Department of Radiation Oncology, National Defense Medical Center, Tri-Service General Hospital (W-YH); Institute of Clinical Medicine, National Yang-Ming University, Taipei (W-YH); School of Medicine, Chung Shan Medical University (H-HC); School of Public Health, Chung Shan Medical University, Taichung (H-HC); Division of Metabolism and Endocrinology, Changhua Christian Hospital, Changhua (H-HC); Division of Metabolism and Endocrinology, Nantou Christian Hospital, Nantou (H-HC); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Szentkirályi A, Völzke H, Hoffmann W, Winkelmann J, Berger K. Lack of Association between Genetic Risk Loci for Restless Legs Syndrome and Multimorbidity. Sleep 2016; 39:111-5. [PMID: 26350469 DOI: 10.5665/sleep.5328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/30/2015] [Indexed: 01/09/2023] Open
Abstract
STUDY OBJECTIVES Multimorbidity is a risk factor for incident restless legs syndrome (RLS). In this relationship, the potential role of known genetic risk loci for RLS has not been studied. Our aim was to evaluate whether carriers of specific RLS risk alleles have higher comorbidity burden than noncarriers. METHODS The Dortmund Health Study (DHS) and the Study of Health in Pomerania (SHIP) are two independent cohort studies in Germany based on age-stratified, random samples drawn from the respective population registers. DHS included 1,312 subjects and SHIP included 4,308 subjects. RLS status was assessed according to the RLS standard minimal criteria. A comorbidity index was calculated by summing the scores of the following conditions: diabetes, hypertension, myocardial infarction, obesity, stroke, cancer, renal disease, anemia, depression, thyroid disease, and migraine. Thirteen single nucleotide polymorphisms (SNP) previously associated with elevated risk of RLS were genotyped. Analyses were carried out on the pooled sample of the two studies. RESULTS The mean age was 50.4 ± 15.9 y, and the proportion of women was 51.4%. The mean number of comorbid conditions was 1.5 ± 1.3. In multivariable regression, the mean number of comorbidities was not significantly different between carriers of any of the RLS risk alleles and noncarriers either in the total pooled sample or in those having RLS symptoms. CONCLUSIONS Based on these results it is unlikely that known genetic risk factors for RLS would lead to increased multimorbidity.
Collapse
Affiliation(s)
- András Szentkirályi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner site Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Germany
| | - Julianne Winkelmann
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Neurology, Technische Universität München, Munich, Germany.,Department of Neurology and Neurosciences, Stanford Center for Sleep Medicine and Sciences, Stanford University, Palo Alto, CA
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| |
Collapse
|
21
|
Gür-Özmen S, Karahan-Özcan R. Iron Deficiency Anemia Is Associated with Menstrual Migraine: A Case–Control Study. PAIN MEDICINE 2015; 17:596-605. [DOI: 10.1093/pm/pnv029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
22
|
Yang FC, Lin TY, Chen HJ, Lee JT, Lin CC, Kao CH. Risk of Restless Legs Syndrome Following Tension-Type Headache: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2015; 94:e2109. [PMID: 26579827 PMCID: PMC4652836 DOI: 10.1097/md.0000000000002109] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Migraine and restless legs syndrome (RLS) appear to be associated, but the relationship between tension-type headache (TTH) and RLS is unknown. This nationwide, population-based, retrospective cohort study explored the potential association between TTH and RLS.We identified 15,504 patients with newly diagnosed TTH from 2000 to 2007 and 62,016 individuals without TTH who were selected by frequency matched based on sex, age, and the index year. The study participants were followed until diagnosed with RLS, withdrawal from the NHI program, or the end of 2011. Cox proportional hazard models were used to identify risk factors for RLS in TTH patients.After adjusting for sex, age, comorbidity, and medications, TTH was significantly associated with an increased risk of RLS (hazard ratio [HR] = 1.57, 95% confidence interval [CI] = 1.22-2.02). The risk was most prominent in patients aged 20 to 39 years in the TTH group, which exhibited a 2.60-fold higher risk (95% confidence interval = 1.53-4.42) of RLS compared with the non-TTH group. The TTH group had a higher risk of RLS than that of the non-TTH group regardless of sex.Tension-type headache appears to be associated with an increased risk of developing RLS. This similarity to migraines may indicate that headache and RLS have a coincident pathophysiological mechanism, a possibility requiring further study. Clinicians should be more attentive to RLS as a possible comorbidity in patients with TTH.
Collapse
Affiliation(s)
- Fu-Chi Yang
- Form the Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (F-CY, J-TL, C-CL); Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (T-YL); Management Office for Health Data, China Medical University Hospital (H-JC); College of Medicine, China Medical University (H-JC); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
| | | | | | | | | | | |
Collapse
|
23
|
Cho SJ, Chung YK, Kim JM, Chu MK. Migraine and restless legs syndrome are associated in adults under age fifty but not in adults over fifty: a population-based study. J Headache Pain 2015; 16:554. [PMID: 26272681 PMCID: PMC4536239 DOI: 10.1186/s10194-015-0554-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent studies have shown an association between migraine and restless legs syndrome (RLS). However, migraine prevalence peaks from the 20s to 40s whereas RLS prevalence peaks after the 50s. Despite this, reports on how migraine and RLS may be associated by age is limited. Therefore, the purpose of this study is to investigate the comorbidity between migraine and RLS according to age. METHODS We selected a stratified random population sample of Koreans aged 19 to 69 years and evaluated them with a 60-item semi-structured interview designed to identify RLS, headache type, and clinical characteristics of migraine. To assess the association between migraine and RLS according to age, we divided participants into 5 age groups (19-29, 30-39, 40-49, 50-59, and 60-69 years) and analysed each group. RESULTS Subjects with migraine showed an increased RLS prevalence in the 19-29 (Odds ratio [OR] = 6.6, 95 % confidence interval [CI] = 1.2-36.8) and 40-49 (OR = 6.7, 95 % CI = 1.5-33.5) age groups compared to non-headache controls but failed to showed a significant association in the 50-59 (OR = 1.1, 95 % CI = 0.2-5.6) and 60-69 (OR = 0.4, 95 % CI = 0.1-4.0) age groups. Migraineurs with 1-10 (12.5 %, OR = 2.0, 95 % CI = 1.3-3.2, p = 0.003) and >10 (12.5 %, OR = 2.5, 95 % CI = 1.0-5.6, p = 0.038) attacks per month showed an increased RLS prevalence compared to migraineurs with <1 attack per month (2.1 %). Subjects with non-migraine headaches showed an increased odds for RLS (OR = 1.8, 95 % CI = 1.3-2.7) compared to non-headache controls. There was no significant difference (9.1 % vs. 6.9 %, p = 0.339) in the RLS prevalence between migraineurs and non-migraine headache subjects. CONCLUSIONS Our results suggest that migraine and RLS are differently associated according to age.
Collapse
Affiliation(s)
- Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | | | | | | |
Collapse
|
24
|
Chen PK, Fuh JL, Wang SJ. Bidirectional triggering association between migraine and restless legs syndrome: A diary study. Cephalalgia 2015. [PMID: 26195587 DOI: 10.1177/0333102415596444] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Migraine is comorbid with restless legs syndrome (RLS). However, the temporal association between these two episodic disorders remains elusive. The current study investigated the temporal relationship between migraine and RLS attacks. METHODS Migraine patients with RLS were recruited from a headache clinic. Patients with symptomatic RLS, RLS mimics, daily headaches, or daily RLS attacks were excluded. The patients recorded their headaches and RLS attacks for two weeks in a diary. The severity of each headache or RLS attack was rated on a four-point (0-3) Likert scale. Logit-normal, random-effects models were employed to estimate the odds ratios (ORs) for the temporal association between migraine and RLS attacks. RESULTS Thirty migraine patients with RLS (28 F/2 M, mean age 35.5 ± 9.0 years) completed the study. On the basis of 420 daily diary records, migraine attacks were associated with subsequent RLS attacks occurring on the same and next nights (OR = 6.94, 95% confidence interval (CI) = 4.39-11.0 and OR = 3.00, CI = 1.92-4.68; both ITALIC! p < 0.001). RLS attacks were associated with subsequent migraine attacks only on Day 1 (OR = 1.97 (CI = 1.3-2.98; ITALIC! p = 0.01). Overall, the frequencies of migraine and RLS attacks in two weeks were correlated (Spearman's correlation = 0.56, ITALIC! p = 0.001). CONCLUSIONS Our study results showed a bidirectional triggering association between migraine and RLS attacks. The association was stronger and lasted longer for migraine triggering subsequent RLS than that for vice versa.
Collapse
Affiliation(s)
- Ping-Kun Chen
- Department of Neurology, Lin-Shin Hospital, Taiwan Department of Neurology, China Medical University Hospital, Taiwan School of Medicine, China Medical University, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan Faculty of Medicine, National Yang-Ming University School of Medicine, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan Faculty of Medicine, National Yang-Ming University School of Medicine, Taiwan Brain Research Center, National Yang-Ming University School of Medicine, Taiwan
| |
Collapse
|
25
|
|
26
|
Headache Syndromes and Sleep. Sleep Med 2015. [DOI: 10.1007/978-1-4939-2089-1_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
27
|
Rist PM, Tzourio C, Elbaz A, Soumaré A, Dufouil C, Mazoyer B, Kurth T. Structural brain lesions and restless legs syndrome: a cross-sectional population-based study. BMJ Open 2014; 4:e005938. [PMID: 25421338 PMCID: PMC4244423 DOI: 10.1136/bmjopen-2014-005938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To evaluate the association between white matter lesion (WML) volume, silent infarcts and restless legs syndrome (RLS) in a population-based study of elderly individuals. DESIGN Cross-sectional study. SETTING Population-based Three-City study. PARTICIPANTS 1035 individuals from the Dijon, France, centre of the Three-City study who had available information on volume of WMLs from MRIs and who answered questions about the prevalence of RLS. PRIMARY OUTCOME MEASURE Prevalence of RLS. RESULTS WML volume was measured using an automated tissue segmentation method. Logistic regression was used to evaluate adjusted associations between tertiles of WML volume and RLS and between silent infarcts and RLS. 218 individuals (21.1%) were determined to have RLS. Compared with those in the first tertile of WML volume, individuals in the second tertile (OR=1.09; 95% CI 0.75 to 1.60) or third tertile (OR=1.17; 95% CI 0.79 to 1.74) did not have an increased prevalence of RLS. We also did not observe associations between the volume of deep or periventricular WML and RLS; nor did we observe an association between silent brain infarcts and RLS (OR=0.74; 95% CI 0.40 to 1.39). These findings were not modified by age or gender. CONCLUSIONS Higher volume of WML and the presence of silent infarcts were not associated with an increased prevalence of RLS in this population-based cohort of elderly individuals.
Collapse
Affiliation(s)
- Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology,Harvard School of Public Health, Boston, Massachusetts, USA
| | - Christophe Tzourio
- INSERM Research Center for Epidemiology and Biostatistics (U897) Team Neuroepidemiology, Bordeaux, France
- College of Health Sciences, University of Bordeaux, Bordeaux, France
| | - Alexis Elbaz
- Social and Occupational Determinants of Health, INSERM, Centre for Research in Epidemiology and Population Health, U1018, Villejuif, France
- Université de Versailles St-Quentin, Versailles, France
| | - Aïcha Soumaré
- INSERM Research Center for Epidemiology and Biostatistics (U897) Team Neuroepidemiology, Bordeaux, France
| | - Carole Dufouil
- INSERM Research Center for Epidemiology and Biostatistics (U897) Team Neuroepidemiology, Bordeaux, France
- College of Health Sciences, University of Bordeaux, Bordeaux, France
| | - Bernard Mazoyer
- College of Health Sciences, University of Bordeaux, Bordeaux, France
- CNRS CEA (UMR5296) Neurofunctional Imaging Group, University of Bordeaux, Bordeaux, France
| | - Tobias Kurth
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology,Harvard School of Public Health, Boston, Massachusetts, USA
- INSERM Research Center for Epidemiology and Biostatistics (U897) Team Neuroepidemiology, Bordeaux, France
- College of Health Sciences, University of Bordeaux, Bordeaux, France
| |
Collapse
|
28
|
Goulart LI, Delgado Rodrigues RN, Prieto Peres MF. Restless Legs Syndrome and Pain Disorders: What’s in common? Curr Pain Headache Rep 2014; 18:461. [DOI: 10.1007/s11916-014-0461-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
29
|
Scher AI, Ross GW, Sigurdsson S, Garcia M, Gudmundsson LS, Sveinbjörnsdóttir S, Wagner AK, Gudnason V, Launer LJ. Midlife migraine and late-life parkinsonism: AGES-Reykjavik study. Neurology 2014; 83:1246-52. [PMID: 25230997 DOI: 10.1212/wnl.0000000000000840] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). METHODS The AGES-Reykjavik cohort (born 1907-1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. RESULTS Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7-4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2-5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3-4.0]) or sibling (ORMA = 1.78 [95% CI 1.1-2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. CONCLUSIONS These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms.
Collapse
Affiliation(s)
- Ann I Scher
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA.
| | - G Webster Ross
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Sigurdur Sigurdsson
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Melissa Garcia
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Larus S Gudmundsson
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Sigurlaug Sveinbjörnsdóttir
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Amy K Wagner
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Vilmundur Gudnason
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| | - Lenore J Launer
- From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA
| |
Collapse
|
30
|
Abstract
OBJECTIVE This narrative review describes the differential diagnosis of restless legs syndrome, and provides an overview of the evidence for the associations between RLS and potential comorbidities. Secondary causes of RLS and the characteristics of pediatric RLS are also discussed. Finally, management strategies for RLS are summarized. METHODS The review began with a comprehensive PubMed search for 'restless legs syndrome/Willis-Ekbom disease' in combination with the following: anxiety, arthritis, attention-deficit hyperactivity disorder, cardiac, cardiovascular disease, comorbidities, depression, end-stage renal disease, erectile dysfunction, fibromyalgia, insomnia, kidney disease, liver disease, migraine, mood disorder, multiple sclerosis, narcolepsy, neuropathy, obesity, pain, Parkinson's disease, polyneuropathy, pregnancy, psychiatric disorder, sleep disorder, somatoform pain disorder, and uremia. Additional papers were identified by reviewing the reference lists of retrieved publications. RESULTS AND CONCLUSIONS Although clinical diagnosis of RLS can be straightforward, diagnostic challenges may arise when patients present with comorbid conditions. Comorbidities of RLS include insomnia, depressive and anxiety disorders, and pain disorders. Differential diagnosis is particularly important, as some of the medications used to treat insomnia and depression may exacerbate RLS symptoms. Appropriate diagnosis and management of RLS symptoms may benefit patient well-being and, in some cases, may lessen comorbid disease burden. Therefore, it is important that physicians are aware of the presence of RLS when treating patients with conditions that commonly co-occur with the disorder.
Collapse
|
31
|
Abstract
Background Headache and sleep mechanisms share multiple levels of physiological interaction. Pharmacological treatment of headache syndromes may be associated with a broad range of sleep disturbances, either as a direct result of the pharmacology of the drug used, or by unmasking physiological alterations in sleep propensity seen as part of the headache symptom complex. Purpose This review summarises known sleep and circadian effects of various drugs commonly used in the management of headache disorders, with particular attention paid to abnormal sleep function emerging as a result of treatment. Method Literature searches were performed using MEDLINE, PubMed, and the Cochrane database using search terms and strings relating to generic drug names of commonly used compounds in the treatment of headache and their effect on sleep in humans with review of additional pre-clinical evidence where theoretically appropriate. Conclusions Medications used to treat headache disorders may have a considerable impact on sleep physiology. However, greater attention is needed to characterise the direction of the changes of these effects on sleep, particularly to avoid exacerbating detrimental sleep complaints, but also to potentially capitalise on homeostatically useful properties of sleep which may reduce the individual burden of headache disorders on patients.
Collapse
Affiliation(s)
- Alexander D Nesbitt
- Headache Group, Department of Clinical Neuroscience, Institute of Psychiatry, King’s College London, UK
- Surrey Sleep Research Centre, University of Surrey, UK
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, UK
| | - Guy D Leschziner
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, UK
| | - Richard C Peatfield
- Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Foundation Trust, UK
| |
Collapse
|
32
|
Schürks M, Winter A, Berger K, Kurth T. Migraine and restless legs syndrome: a systematic review. Cephalalgia 2014; 34:777-94. [PMID: 25142142 DOI: 10.1177/0333102414537725] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine. METHODS We conducted a systematic review and meta-analysis of studies investigating RLS in headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations. RESULTS We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07-5.71; I (2) = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14-1.30; I (2) = 0.0%). CONCLUSION Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
Collapse
Affiliation(s)
- Markus Schürks
- Department of Neurology, University Hospital Essen, Germany
| | - Anke Winter
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
| | - Tobias Kurth
- Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA College of Health Sciences, University of Bordeaux, France Inserm Research Center for Epidemiology and Biostatistics - Team Neuroepidemiology, Bordeaux, France
| |
Collapse
|
33
|
Gupta R, Spence D, BaHammam A, Monti J, Pandi-Perumal S. Association between migraine and restless legs syndrome. SOMNOLOGIE 2014. [DOI: 10.1007/s11818-013-0650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
Zanigni S, Giannini G, Melotti R, Pattaro C, Provini F, Cevoli S, Facheris MF, Cortelli P, Pramstaller PP. Association between restless legs syndrome and migraine: a population-based study. Eur J Neurol 2014; 21:1205-10. [PMID: 24840006 DOI: 10.1111/ene.12462] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 04/07/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE A higher prevalence of restless legs syndrome (RLS) in migraineurs has been reported in clinical samples and in two large-scale clinical trials performed on healthcare workers but general population-based studies on this topic are lacking. The aim of this study was to assess the association between migraine and RLS in an Italian rural adult population-based setting. METHODS The presence of migraine and RLS was assessed via a computer-assisted personal interview and self-administered questionnaires according to current diagnostic criteria in 1567 participants of a preliminary phase of an adult population-based study performed in South Tyrol, Italy. RESULTS Migraineurs had an increased risk of having RLS also after adjustment for confounding factors such as age, sex, major depression, anxiety and sleep quality (odds ratio 1.79; confidence interval 1.00-3.19; P = 0.049). This association was not modified by aura status and possible causes of secondary RLS. RLS was not significantly associated with tension-type headache. CONCLUSIONS Restless legs syndrome and migraine were associated in our rural adult population. This association could be explained by a possible shared pathogenic pathway which would implicate new management strategies of these two disorders.
Collapse
Affiliation(s)
- Stefano Zanigni
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC) (Affiliated Institute of the University of Lübeck), Bozen/Bolzano, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Fernández-Matarrubia M, Cuadrado ML, Sánchez-Barros CM, Martínez-Orozco FJ, Fernández-Pérez C, Villalibre I, Ramírez-Nicolás B, Porta-Etessam J. Prevalence of migraine in patients with restless legs syndrome: a case-control study. Headache 2014; 54:1337-46. [PMID: 24842340 DOI: 10.1111/head.12382] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess and compare the prevalence of migraine in patients with restless legs syndrome (RLS) and matched controls. BACKGROUND Recent studies have suggested an association between migraine and RLS. Our work is the first case-control study on this subject performed in an RLS population. METHODS A case-control study was conducted in 47 RLS patients (27 women and 20 men aged between 18 and 65 years) and 47 age- and sex-matched controls. Validated questionnaires were used to investigate the presence of migraine, anxiety, and depression (Zung Self-Rating Anxiety and Depression scales), sleep quality (Pittsburgh Sleep Quality Index), and RLS severity (International RLS scale). RESULTS RLS patients had higher lifetime prevalence of migraine than non-RLS controls (53.2% vs. 25.5%, P = .005; matched-OR 1.3 [P = .019]; adjusted odds ratio (OR) 3.8 [P = .03]). No significant associations were found between RLS and active migraine with aura or inactive migraine (no episodes in the previous year). However, active migraine without aura was significantly more prevalent in patients with RLS than in controls (40.4% vs. 12.8%, P = .001; matched OR 1.5 [P = .001]; adjusted OR 2.7 [P = .04]). Within the RLS group, patients with migraine had poorer sleep quality than those without migraine (Pittsburgh Sleep Quality Index >5:100 vs. 80.9%, P = .038) but did not differ in terms of RLS severity, anxiety and depression, use of dopaminergic agonists, and body mass index. CONCLUSION There appears to be a relationship between RLS and migraine, in particular for active migraine without aura.
Collapse
Affiliation(s)
- Marta Fernández-Matarrubia
- Headache Unit, Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Abstract
Headache and sleep problems are both some of the most commonly reported symptoms in clinical practice. There is a clear association between chronic headache and sleep disorders, especially headaches occurring during the night or early morning. Identification of sleep problems in chronic headache patients is worthwhile because treatment of sleep disorders among chronic headache patients may be followed by improve of the headache. Morning headache has been recognised as an obstructive sleep apnoea related symptom. Treatment with continuous positive airway pressure usually reduced headache, however, we often encounter obstructive sleep apnoea patients who present various characteristics of morning headache that often do not fulfil the criteria for "sleep apnoea headache" according to the International Classification of Headache Disorders: 2nd edition (ICHD-2) criteria. The pathophysiologic background for a relation between obstructive sleep apnoea and morning headache is multifactorial. We should also be noted that tension-type headache and migraine might be coexisted in obstructive sleep apnoea patients. In addition, we review the relationship between migraine and sleep disorders such as restless legs syndrome, narcolepsy and parasomnia (dream enacting behaviour) including our studies.
Collapse
|
37
|
Seidel S, Frantal S, Salhofer-Polanyi S, Lieba-Samal D, Zeitlhofer J, Wöber C. Do nocturnal headaches matter? A prospective diary study on subjective sleep parameters in snorers and their bed partners. Cephalalgia 2013; 34:533-9. [PMID: 24326235 DOI: 10.1177/0333102413515347] [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: 08/16/2013] [Accepted: 10/29/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND The objective of this study was to assess the influence of nocturnal headaches (NH) on subjective sleep parameters prospectively in habitual snorers and their bed partners. METHODS We recruited habitual snorers and their bed partners via newspaper articles. The participants completed a semistructured interview, filled in questionnaires about quality of sleep (PSQI), daytime sleepiness (ESS), depression (SDS) and anxiety (SAS) and they kept a 90-day headache and sleep diary. RESULTS Seventy-six snorers (25 female) and 41 bed partners (31 female) completed the study recording a total of 6690 and 3497 diary days, respectively. NH were recorded on 222 (3.3%) and 79 (2.2%) days in 32 (42%) snorers and 17 (41%) bed partners, respectively. Snorers with NH showed significantly higher PSQI (5 ± 3 vs. 4 ± 2, p = 0.004), SAS (38 ± 11 vs. 31 ± 10, p = 0.011) and SDS scores (39 ± 12 vs. 34 ± 10, p = 0.048) than snorers without NH. For bed partners with NH we found a significant female predominance (sex ratio f:m = 16:1 vs. 12:12, p = 0.005) and significantly higher SAS scores (38 ± 6 vs. 33 ± 8, p = 0.030) compared with bed partners without NH. The subjective quality of sleep in habitual snorers (p < 0.001) as well as their bed partners (p = 0.017) was negatively influenced by NH, but not total sleep time. DISCUSSION NH occurred in around 40% of snorers and their bed partners at least once during the 90-day observation period. Our results confirmed a negative impact on the subjective quality of sleep in both groups.
Collapse
Affiliation(s)
- Stefan Seidel
- Department of Neurology, Medical University of Vienna, Austria
| | - Sophie Frantal
- Department of Medical Statistics, Medical University of Vienna, Austria
| | | | | | | | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Austria
| |
Collapse
|
38
|
Suzuki K, Suzuki S, Miyamoto M, Miyamoto T, Numao A, Watanabe Y, Takashima R, Hirata K. Does pramipexole treatment improve headache in patients with concomitant migraine and restless legs syndrome? Tremor Other Hyperkinet Mov (N Y) 2013; 3:tre-03-176-4234-1. [PMID: 24116342 PMCID: PMC3779820 DOI: 10.7916/d8xd10d9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 07/08/2013] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent studies have suggested a strong link between migraines and restless legs syndrome (RLS). It is possible that these disorders share a dopaminergic dysfunction in the hypothalamic A11 nucleus that contributes to this association. However, there have been no clinical studies to evaluate the effect of dopaminergic treatment on migraine symptoms in patients with concomitant migraines and RLS. METHODS We present an illustrative patient with concomitant RLS and migraine who showed improvement in her headache frequency and RLS symptoms following immediate-release pramipexole (P-IR) treatment and provide review results from the medical records of patients who experienced both migraines and RLS in our previous cross-sectional study. RESULTS Ten patients (nine patients from the previously completed single-center study) received P-IR treatment were included in the study. RLS symptoms improved markedly in all of the subjects. Five out of the 10 patients (50%) reported improvement in migraine headaches. Of these five patients, four (80%) had reported morning headaches before P-IR treatment. DISCUSSION Our results indicate that the identification of RLS in migraine patients is clinically significant and that dopaminergic treatment may improve both migraines, particularly morning headache (80% improvement in this study), and RLS symptoms. However, further clinical studies are warranted to verify our results.
Collapse
Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Ayaka Numao
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yuka Watanabe
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| |
Collapse
|
39
|
Fonteh AN, Pogoda JM, Chung R, Cowan RP, Harrington MG. Phospholipase C activity increases in cerebrospinal fluid from migraineurs in proportion to the number of comorbid conditions: a case-control study. J Headache Pain 2013; 14:60. [PMID: 23826990 PMCID: PMC3704687 DOI: 10.1186/1129-2377-14-60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/29/2013] [Indexed: 12/30/2022] Open
Abstract
Background Migraineurs are more often afflicted by comorbid conditions than those without primary headache disorders, though the linking pathophysiological mechanism(s) is not known. We previously reported that phosphatidylcholine-specific phospholipase C (PC-PLC) activity in cerebrospinal fluid (CSF) increased during migraine compared to the same individual’s well state. Here, we examined whether PC-PLC activity from a larger group of well-state migraineurs is related to the number of their migraine comorbidities. Methods In a case–control study, migraineurs were diagnosed using International Headache Society criteria, and controls had no primary headache disorder or family history of migraine. Medication use, migraine frequency, and physician-diagnosed comorbidities were recorded for all participants. Lumbar CSF was collected between the hours of 1 and 5 pm, examined immediately for cells and total protein, and stored at −80°C. PC-PLC activity in thawed CSF was measured using a fluorometric enzyme assay. Multivariable logistic regression was used to evaluate age, gender, medication use, migraine frequency, personality scores, and comorbidities as potential predictors of PC-PLC activity in CSF. Results A total of 18 migraineurs-without-aura and 17 controls participated. In a multivariable analysis, only the number of comorbidities was related to PC-PLC activity in CSF, and only in migraineurs [parameter estimate (standard error) = 1.77, p = 0.009]. Conclusion PC-PLC activity in CSF increases with increasing number of comorbidities in migraine-without-aura. These data support involvement of a common lipid signaling pathway in migraine and in the comorbid conditions.
Collapse
Affiliation(s)
- Alfred N Fonteh
- Molecular Neurology Program, Huntington Medical Research Institutes, 99 N El Molino Ave, Pasadena, CA 91101, USA.
| | | | | | | | | |
Collapse
|
40
|
Ferreira KS, Eckeli A, Dach F, Speciali JG. Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 71:87-91. [PMID: 23306209 DOI: 10.1590/s0004-282x2013005000007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 08/07/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The pathophysiology of migraine and restless legs syndrome (RLS) seems to involve inherited mechanism and dysfunction of the dopaminergic system. Previous articles have shown that the frequency of RLS is higher in migraine patients than in controls. We conducted a study to evaluate comorbidities, medication used and depressive symptoms that can explain the relation between migraine and RLS. METHODS A case-control study was performed in which patients with migraine (n=72) and a control group without migraine (n=72) were interviewed. Data including RLS diagnosis, depressive symptoms, comorbidities and drugs used were evaluated. RESULTS There was a significant association between migraine and RLS (p=0.01), but comorbidities such as diabetes, hypertension, anemia and drugs used did not explain this association. Depression scores, as measured by the Beck Depression Inventory, were higher in migraine patients with RLS (p =0.04). CONCLUSION No specific factors explaining the association between migraine and RLS were found. Symptoms of depression were more frequent in patients with migraine and RLS.
Collapse
Affiliation(s)
- Karen S Ferreira
- Department of Neuroscience, Medical School at Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil.
| | | | | | | |
Collapse
|
41
|
Barbanti P, Aurilia C, Egeo G, Fofi L, Vanacore N. A case-control study on excessive daytime sleepiness in chronic migraine. Sleep Med 2013; 14:278-81. [PMID: 23317931 DOI: 10.1016/j.sleep.2012.10.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 10/11/2012] [Accepted: 10/31/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Excessive daytime sleepiness is a major clinical and health concern that can have varied and sometimes harmful consequences. Findings from uncontrolled studies suggest a high prevalence in patients with chronic migraine. METHODS In a case-control study, we compared frequency data for excessive daytime sleepiness in 100 patients with chronic migraine and 100 healthy controls paired for sex and age, and assessed risk factors including lifestyle, sleep quality, anxiety, depression, concomitant disease and medications. RESULTS The frequency of excessive daytime sleepiness was higher in migraineurs (especially in those with medication overuse) than in controls (20% versus 6%; odds ratio 3.92, 95% CI 1.5-10.22), but was lower than previously reported and correlated with poor quality sleep and anxiolytic and antidepressant use. CONCLUSIONS Again confirming that disability in chronic migraine is multifactorial in origin, excessive daytime sleepiness, especially in migraineurs who overuse medications, adds to the multiple factors known to impair social and working function. Patients with chronic migraine might benefit from diagnostic interviews focussing also on sleep problems and from targeted psychoactive drug prescribing.
Collapse
Affiliation(s)
- Piero Barbanti
- Headache and Pain Unit, IRCCS San Raffaele Pisana, Via della Pisana 235, 00163 Rome, Italy.
| | | | | | | | | |
Collapse
|
42
|
Winter AC, Schürks M, Berger K, Buring JE, Gaziano JM, Kurth T. Migraine and restless legs syndrome in men. Cephalalgia 2012; 33:130-5. [PMID: 23155191 DOI: 10.1177/0333102412466965] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies suggest an association between migraine and restless legs syndrome (RLS). Population-based data, however, have been limited to women. The aim of this study is to evaluate the association between migraine and RLS in a male cohort. METHODS We conducted a cross-sectional study among 22,926 participants in the Physicians' Health Study. Migraine and RLS information was self-reported. RLS was classified according to four minimal diagnostic criteria. Age- and multivariable-adjusted logistic regression models were calculated. RESULTS Of the 22,926 participants (mean age 67.8), 2816 (12.3%) reported migraine and 1717 (7.5%) RLS. Migraine was associated with an increased multivariable-adjusted odds ratio (OR) (95% confidence interval (CI)) of 1.20 (1.04-1.38) for having RLS. The association remained stable after excluding men with potential mimics of RLS and was not modified by age. CONCLUSIONS Results of our study indicate an association between migraine and RLS in men. The magnitude of effect is similar to what has been reported in women.
Collapse
Affiliation(s)
- Anke C Winter
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | | | | | | | | | | |
Collapse
|
43
|
Seidel S, Böck A, Schlegel W, Kilic A, Wagner G, Gelbmann G, Hübenthal A, Kanbur I, Natriashvili S, Karwautz A, Wöber C, Wöber-Bingöl C. Increased RLS prevalence in children and adolescents with migraine: a case-control study. Cephalalgia 2012; 32:693-9. [PMID: 22659118 DOI: 10.1177/0333102412446207] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous studies have reported an increased frequency of restless legs syndrome (RLS) in adult migraine patients. Until now, the frequency of RLS in pediatric patients has not been investigated. We set out to assess the frequency of RLS in children and adolescents with migraine compared to headache-free controls. METHODS We investigated 111 consecutive patients with a sole diagnosis of migraine with or without aura presenting to the Headache Unit at the Department of Child and Adolescent Psychiatry and 73 headache-free controls for the presence of RLS using a semistructured interview. In addition, we assessed the level of daytime sleepiness by means of the Epworth sleepiness scale (ESS). A second group of headache-free controls was screened for the presence of RLS using an online questionnaire. RESULTS The frequency of RLS in migraine patients was significantly higher than in controls (22% vs. 5% (p < 0.001) and 8% (p < 0.001)). DISCUSSION This is the first study suggesting an association between RLS and migraine in the pediatric population. Future studies are needed to determine the extent of sleep disruption in children and adolescents with migraine and comorbid RLS.
Collapse
Affiliation(s)
- Stefan Seidel
- Headache Unit at the Department of Neurology, Medical University of Vienna, Austria
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|