Clinical and neurophysiological features of the augmentation phenomenon in restless legs syndrome
Notice bibliographique
Résumé
Anxiety and depressive disorders are common in restless legs syndrome (RLS); in some cases, the disease is accompanied by cognitive impairment and a deterioration in quality of life. The most important treatment method for RLS is the use of dopaminergic medications. In some cases, the use of these drugs leads to a complication - the phenomenon of augmentation, which manifests itself in an increase in RLS symptoms as the dose of medication increases. Objective : to determine the clinical and neurophysiological characteristics of RLS patients with the augmentation phenomenon. Material and methods . 40 patients with RLS were examined: 20 with augmentation (main group, MG; 5 men and 15 women) and 20 without augmentation (comparison group, CG; 7 men and 13 women). The median age of the patients in the MG was 63.5 [56; 71] years, and 62.0 [43.5; 71.5] years in the CG. Clinical assessment was performed using the RLS Severity Rating Scale (RS), Montreal Cognitive Assessment Scale (MoCA), Beck Anxiety Inventory, Beck Depression Inventory, Quality of Life Scale (SF-36), Insomnia Severity Index (ISI), Trail Making Test (Part A), Trail Making Test (part B), phonemic and semantic speech activity tests. All patients underwent suggested immobilization test (SIT) to assess the urge to move on a 10-point numerical rating scale (NRS) and periodic limb movements (PLM) while awake, as well as a polysomnographic examination. Results . Augmentation significantly more frequently resulted in an expansion of the area of distribution of the urge to move and other unpleasant sensations over the entire surface of the legs (p=0.01), painful discomfort in the legs (p=0.001), early onset of symptoms (04:00—18:00; p=0.04), shortening of the latency period for the onset of symptoms (p=0.001), twitching in the legs while awake (p=0.04), taking higher doses of dopaminergic medications (p=0.004). In augmentation, the MoCA score is lower (p=0.01), such patients use fewer words in the semantic speech activity test (p=0.049), have a higher score on the RS (p=0.001) and ISI (p=0.02), a greater number of PLMs while awake according to SIT (p=0.01) compared to CG. No significant differences were found between groups in terms of age, gender, ferritin level, total score on the Beck Anxiety and Depression Inventory, SF-36 Quality of Life Scale, Trail Making Test (Part A), Trail Making Test (part B), phonemic speech activity test, polysomnography indicators (including motor activity during sleep). Conclusion . From a clinical and neurophysiological point of view, the phenomenon of augmentation is not simply a manifestation of a more severe course of RLS but has features that reflect the pathogenesis of this disorder. During augmentation, patients tend to describe the sensations as painful and their involuntary motor activity increases. This reflects changes in the activity of the diencephalospinal tract due to excessive dopaminergic stimulation.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».