Trenkwalder Claudia, Allen Richard, Högl Birgit, Paulus Walter, Winkelmann Juliane
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.
Neurology. 2016 Apr 5;86(14):1336-1343. doi: 10.1212/WNL.0000000000002542. Epub 2016 Mar 4.
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.
近期有关被定义为一种临床病症的不宁腿综合征（RLS）的遗传学和环境因素的出版物表明，重叠的遗传风险因素可能在原发性（特发性）和继发性（症状性）RLS中起作用。在对与共病相关的RLS进行系统的文献检索后，我们发现仅在缺铁和肾脏疾病中RLS的患病率有所增加。在心血管疾病、动脉高血压、糖尿病、偏头痛和帕金森病中，研究方法欠佳，但可能存在关联。对于贫血（无缺铁）、慢性阻塞性肺疾病、多发性硬化症、头痛、中风、发作性睡病和共济失调等病症，证据不足。基于可能的基因-微环境相互作用，原发性和继发性RLS的分类可能暗示了不恰当的因果关系。我们认识到，在某些情况下，应尽可能对基础疾病进行治疗，以减轻或消除RLS症状。RLS可能被视为一个连续谱，一端主要由遗传因素决定，另一端主要由环境或共病因素决定。
