Interesting update on RLS... clearly associated with iron deficiency anaemia and kidney disease, but other disease associations may be explained (at least in part) by bias and confounding. The spectrum of causal factors that underlie RLS is wide and current clinical categorisation may fail to capture that... and may have implications on treatment...
Neurology. 2016 Mar 4. pii: 10.1212/WNL.0000000000002542. [Epub ahead of print]
Trenkwalder C, Allen R, Högl B, Paulus W, Winkelmann J.
Recent publications on both the genetics and environmental factors of restless legs syndrome (RLS) defined as a clinical disorder suggest that overlapping genetic risk factors may play a role in primary (idiopathic) and secondary (symptomatic) RLS. Following a systematic literature search of RLS associated with comorbidities, we identified an increased prevalence of RLS only in iron deficiency and kidney disease. In cardiovascular disease, arterial hypertension, diabetes, migraine, and Parkinson disease, the methodology of studies was poor, but an association might be possible. There is insufficient evidence for conditions such as anemia (without iron deficiency), chronic obstructive pulmonary disease, multiple sclerosis, headache, stroke, narcolepsy, and ataxias. Based on possible gene-microenvironmental interaction, the classifications primary and secondary RLS may suggest an inappropriate causal relation. We recognize that in some conditions, treatment of the underlying disease should be achieved as far as possible to reduce or eliminate RLS symptoms. RLS might be seen as a continuous spectrum with a major genetic contribution at one end and a major environmental or comorbid disease contribution at the other.
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