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不宁腿综合征与其他运动障碍的关联。

Association between restless legs syndrome and other movement disorders.

机构信息

From the Section of Neurology (H.A.-N., F.J.J.-J.), Hospital Universitario del Sureste, Arganda del Rey, Madrid; and University Institute of Molecular Pathology Biomarkers (E.G.-M., J.A.G.A), UNEx, ARADyAL Instituto de Salud Carlos III, Cáceres, Spain.

出版信息

Neurology. 2019 May 14;92(20):948-964. doi: 10.1212/WNL.0000000000007500. Epub 2019 Apr 19.

Abstract

OBJECTIVE

This review focuses on the possible association between restless legs syndrome (RLS) and movement disorders, including Parkinson disease (PD), other parkinsonian syndromes, essential tremor, choreic and dystonic syndromes, Tourette syndrome, and heredodegenerative ataxias.

METHODS

Review of PubMed from 1966 to September 2018 and identification of references of interest for the topic. A meta-analysis of eligible studies on the frequency of RLS in patients with PD and controls using Meta-DiSc1.1.1 software and using the PRISMA guidelines was performed.

RESULTS AND CONCLUSIONS

Although there are substantial clinical, neuroimaging, neuropathologic, and genetic differences between RLS and PD, many reports describe a higher than expected prevalence of RLS in patients with PD, when compared with the general population or with matched control groups; several studies have also suggested that RLS could be an early clinical feature of PD. RLS symptoms are frequent in multiple system atrophy, essential tremor, Tourette syndrome, Friedreich ataxia, and spinocerebellar ataxia type 3 as well. Finally, possible genetic links between PD and RLS (the presence of allele 2 of the complex microsatellite repeat Rep1 within the α-synuclein gene promoter) and between Tourette syndrome and RLS (several variants in the gene) have been reported in 2 case-control association studies, although these data, based on preliminary data with small sample sizes, need to be replicated in further studies.

摘要

目的

本综述重点探讨不宁腿综合征(RLS)与运动障碍之间的可能关联,包括帕金森病(PD)、其他帕金森综合征、特发性震颤、舞蹈症和肌张力障碍综合征、妥瑞氏综合征和遗传性共济失调。

方法

检索 1966 年至 2018 年 9 月期间的 PubMed 数据库,并对与该主题相关的参考文献进行筛选。使用 Meta-DiSc1.1.1 软件对 PD 患者和对照组中 RLS 频率的合格研究进行 Meta 分析,并遵循 PRISMA 指南。

结果与结论

尽管 RLS 和 PD 在临床、神经影像学、神经病理学和遗传学方面存在很大差异,但许多报告描述了 PD 患者中 RLS 的患病率高于预期,与普通人群或匹配对照组相比;一些研究还表明,RLS 可能是 PD 的早期临床特征。RLS 症状在多系统萎缩、特发性震颤、妥瑞氏综合征、弗里德里希共济失调和脊髓小脑性共济失调 3 型中也很常见。最后,在 2 项病例对照关联研究中报道了 PD 和 RLS 之间(α-突触核蛋白基因启动子中复杂微卫星重复 Rep1 等位基因 2 的存在)和妥瑞氏综合征和 RLS 之间(基因中的几个变体)可能存在遗传联系,尽管这些数据基于样本量较小的初步数据,需要在进一步的研究中进行复制。

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