Restless leg syndrome in individuals with Parkinson disease can be treated with subthalamic nucleus deep brain stimulation, according to a study published in Neurology. This improvement shows evidence of long-term efficacy and can be sustained even with reduced dopaminergic therapy.
Investigators conducted a retrospective study which included 22 participants from the University of Colorado Hospital from January 2008 to December 2013. Individuals in this study underwent subthalamic nucleus deep brain stimulation surgery and completed the Restless Leg Syndrome Quality of Life and International Restless Leg Syndrome Study (IRLS) Study Group Rating Scale both before surgery and at 6, 12, and 24 months after surgery. IRLS cumulative score and severity and impact subscales were the primary outcomes, with the secondary outcome being scores on quality of life. A mixed model regression was used to investigate differences in mean scores over time.
Before surgery, the participants’ IRLS Group Rating Scale cumulative score was 19.59 ± 6.95, the impact subscale was 4.45 ± 2.72, severity subscale was 12.91 ± 4.33, and the transformed restless leg syndrome quality of life score was 68.39 ± 20.26. After surgery, the respective changes were -7.80, -1.20, -5.50, and +4.73, respectively. There were differences in the means of the IRLS total and subscales in terms of times, which were identified using F tests (P<.05). Improvement in symptoms of restless leg syndrome was not associated with either improvements in Parkinson disease motor symptoms or Parkinson disease medications. A 50% improvement was seen in half of all participants, whereas restless leg syndrome symptoms were resolved (IRLS = 0) in 27%.
Study researchers conclude that “[subthalamic nucleus deep brain stimulation] significantly decreased [restless leg syndrome] symptoms in patients with [Parkinson disease] despite a decrease in dopaminergic treatment. This improvement was sustained over a 2-year period.”
Klepitskaya O, Liu Y, Sharma S, Sillau SH, Tsai J, Walters AS. Deep brain stimulation improves restless legs syndrome in patients with Parkinson disease [published online August 15, 2018]. Neurology. doi: 10.1212/WNL.0000000000006162