Clinical And Sonographic Characteristics Of Parkinson ’S Disease With Symptom Of Restless Legs Syndrome:A Multicenter,Cross-sectional Study

Objective:To evaluate the clinical and transcranial sonographic characteristics in patients with Parkinson’s disease(PD)with symptom of restless legs syndrome(RLS).Methods:We consecutively enrolled patients with diagnosis of definite PD from the Second Affiliated Hospital of Soochow University and other 4 participating hospitals from June,2017 to November,2018.Concurrent RLS symptom was determined based on the 26th item of Non-motor Symptoms Questionnaire(NMSQ).Motor symptoms were evaluated using Unified Parkinson Disease Rating Scale part Ⅲ(UPDRS-Ⅲ).Non-motor symptoms were evaluated using NMSQ,Hamilton Depression Scale-24 item(HAMD-24)and REM sleep behavior disorder questionnaire-Hong Kong(RBD-HK).Transcranial sonography(TCS)was conducted simultaneously as evaluation and clinical and sonographic parameters were compared between groups.We applied logistic regression model to test the association between RLS symptom and clinical characteristic after adjusting for potential confounders and explored the risk factors of developing RLS symptom in patients with PD.Results:Among 349 patients with PD,the prevalence of RLS symptom was 22.6%.Compared with patients without RLS symptom,those with RLS symptom had longer disease duration and higher H-Y stage.Patients with RLS symptom had higher scores on UPDRS-Ⅲ,NMSQ,HAMD-24 and RBD-HK,were more likely to experience bradykinesia,postural and gait instability and had problems on depression,sleep disorders and cardiac autonomic function.Non-tremor dominant motor subtype,higher RBD-HK scores and higher HAMD-24 scores could be risk factors of having RLS symptoms in PD patients.TCS revealed that PD patients with RLS symptom were more likely to have abnormal echogenity on raphe nucleus and increased third ventricle width,but no significant differences were observed on parameters of substantia nigra.Conclusion:RLS symptom is common in PD patients.Patients with PD and RLS symptom had severer motor symptoms and non-motor symptoms such as depression and sleep disorder.In patients with PD,abnormal echogenity of raphe nucleus and increased third ventricle width may help to identify concurrent RLS symptom.