Zusammenfassung
Hintergrund
Das Restless-legs-Syndrom (RLS) ist ein häufiges neurologisches Krankheitsbild. Studien zeigten, dass es mit internistischen und neurologischen Erkrankungen assoziiert auftritt.
Ziele
Anhand dreier assoziierter neurologischer Erkrankungen soll die Bedeutung des RLS für die neurologische Versorgung beurteilt werden.
Material und Methoden
Mittels systematischer Recherche in PubMed hinsichtlich sämtlicher Studien zum RLS in Kombination mit Polyneuropathien (PNP), der Parkinson-Erkrankung (PD) und Multipler Sklerose (MS) erfolgte eine Einordnung nach Methodik und Aufbau in hohe, mittlere oder geringe Studienqualität.
Ergebnisse
Von 16 Studien zum RLS und MS wurden 10 als „hoch“ eingestuft. Die hohe Assoziationsbreite zwischen 13,3 bis zu 65,1 % aufgrund unterschiedlicher Methodik verhindert trotz der eindeutig erhöhten Prävalenz eine zusammenfassende Aussage. Bei 30 Studien zum idiopathischen Parkinson-Syndrom wurden 17 mit hoher Qualität gefunden. Das RLS tritt mit dem idiopathischen Parkinson-Syndrom nur unter Therapie gehäuft auf und hier proportional zur Dauer der dopaminergen Behandlung. Von 24 Studien zu PNP wurden nur 5 als „hoch“ eingestuft, eine erhöhte RLS-Prävalenz wurde für die erworbene PNP nachgewiesen mit heterogener Datenlage für hereditäre Formen.
Schlussfolgerung
Für die diskutierten Erkrankungen besteht eine erhöhte Prävalenz für eine Assoziation mit RLS, die möglicherweise pathophysiologisch durch die Erkrankungen bestimmt wird. Aber auch hier liegen möglicherweise genetische Prädispositionen vor, die in Zukunft hoffentlich genauer klassifiziert werden können.
Abstract
Background
Restless legs syndrome (RLS) is a common neurological disease. Studies have shown that RLS is associated with a variety of medical and neurological disorders.
Objectives
Using the example of three associated neurological diseases, the significance for everyday therapy decisions is assessed.
Material and methods
A systematic search was carried out in PubMed for all studies with the keyword “RLS” in combination with polyneuropathies (PNP), Parkinson’s disease (PD) and multiple sclerosis (MS) and classified according to the methodology in high, medium or low study quality.
Results
Of 16 studies on RLS and MS, 10 were rated as “high”. The high association frequency of RLS in MS between 13.3% and 65.1% (the variability possibly originates from different methods) prevents further statements about the prevalence. Within 30 studies on Parkinson’s disease 17 were classified as having a high quality. In patients with Parkinson disease RLS occurs most frequently during therapy and is related to the duration of dopaminergic treatment. In patients with polyneuropathy, only 5 out of 24 studies were classified as being of high quality and an increased RLS prevalence was detected for acquired polyneuropathies with heterogeneous data for hereditary forms.
Conclusion
There is an increased prevalence of association with RLS for the diseases discussed. This prevalence is possibly determined by the pathophysiology of these disorders. These diseases are possibly characterized by genetic predispositions as well, which can hopefully be classified more accurately in the future.
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Interessenkonflikt
J. Winkelmann gibt folgende Interessenkonflikte an: Förderungen von DFG, Era Net Neuron, Deutsche RLS-Vereinigung. Honorare von Bayer Vital GmbH, UCB. Weiterhin ein angemeldetes Patent: 17 15 6438.8. B. Högl gibt folgende Interessenkonflikte an: Vortragshonorare von Lundbeck, Lilly, Janssen Cilag, Otsuka, Abbvie, UCB, Mundipharma. Beratung für Axovant, Benevolent Bio und Mundipharma. Reisekostenübernahme von Air Liquide und Habel Medizintechnik, Wien. C. Trenkwalder gibt folgende Interessenkonflikte an: Tätigkeit in Advisory Boards von: Gruenenthal, UCB, Vifor Pharma, Britannia Pharmaceuticals, Benevolent Bio, Novartis. Vortragshonorare von: UCB, Britannia, Mundipharma, Abbvie, Servier. Lizenzgebühren vom: Schattauer Verlaggeben. M. Bartl und W. Paulus geben an, dass kein Interessenkonflikt besteht.
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Bartl, M., Winkelmann, J., Högl, B. et al. Häufige neurologische Erkrankungen assoziiert mit dem Restless-legs-Syndrom. Nervenarzt 89, 1156–1164 (2018). https://doi.org/10.1007/s00115-018-0528-y
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DOI: https://doi.org/10.1007/s00115-018-0528-y