Neurology, Neurobiology, Neurophysiology and Psychiatry; Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Neurol Sci. 2024 May;45(5):2325-2329. doi: 10.1007/s10072-024-07342-w. Epub 2024 Jan 29.
Restless leg syndrome (RLS) is an invalidating neurological disorder with a complex, largely unknown pathophysiology. While RLS is observed in Parkinson's disease and in renal failure, idiopathic cases are common. Limited reports associate RLS with parathyroid hormone (PTH). This study analyzes a cohort of patients with primary hyperparathyroidism (PHPT) and chronic post-surgical hypoparathyroidism (hypo PTH), to investigate RLS prevalence, and associated risk factors.
Ninety-five patients (54 PHPT, 41 hypo PTH) were consecutively enrolled at the bone metabolism outpatient clinic. The revised IRLSSG diagnostic criteria were used to diagnose RLS, with assessments conducted through face-to-face interviews and neurological examination. When RLS was confirmed, the RLS severity scale was applied. Retrospective records included calcium-phosphate metabolism-related parameters, surgery details, renal lithiasis, fragility fractures, and densitometric features (T-score).
RLS was diagnosed in 22.2% PHPT patients, compared to 4.9% of patients with hypo PTH (p = 0.02). Of RLS diagnosed patients, 91.7% had a history of parathyroidectomy, compared to 47.6% of patients without RLS (p = 0.01). Most of the operated patients reported that surgery determined an improvement of symptoms; however, mean score severity of RLS at our evaluation was 15/40, defined as moderate. PTH and calcium levels were not statistically associated to the presence of RLS.
Our study suggests that PHPT may be one of the etiologies of RLS. Parathyroidectomy alleviates symptoms in the vast majority of the cases but does not remove them.
不宁腿综合征（RLS）是一种使人丧失能力的神经紊乱疾病，其发病机制复杂，很大程度上仍不为人知。RLS 可见于帕金森病和肾衰竭患者中，但更多见的是特发性病例。有限的报告将 RLS 与甲状旁腺激素（PTH）联系起来。本研究分析了一组原发性甲状旁腺功能亢进症（PHPT）和慢性手术后甲状旁腺功能减退症（hypo PTH）患者，以调查 RLS 的患病率及其相关的危险因素。
95 名患者（54 例 PHPT，41 例 hypo PTH）连续在骨代谢门诊就诊。采用修订后的 IRLSSG 诊断标准诊断 RLS，通过面对面访谈和神经系统检查进行评估。当 RLS 得到确认时，应用 RLS 严重程度量表进行评估。回顾性记录包括钙磷代谢相关参数、手术细节、肾结石、脆性骨折和骨密度特征（T 评分）。
PHPT 患者中 RLS 的诊断率为 22.2%，而 hypo PTH 患者为 4.9%（p=0.02）。在确诊为 RLS 的患者中，91.7%有甲状旁腺切除术史，而无 RLS 的患者中这一比例为 47.6%（p=0.01）。大多数接受手术的患者报告说手术改善了症状；然而，在我们的评估中，RLS 的平均严重程度评分为 15/40，定义为中度。PTH 和钙水平与 RLS 的存在无统计学关联。
我们的研究表明，PHPT 可能是 RLS 的病因之一。甲状旁腺切除术在绝大多数情况下缓解了症状，但并未消除症状。
