Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

Abstract Small fiber neuropathy (SFN) has been suggested as a trigger of restless legs syndrome (RLS). An increased prevalence of peripheral neuropathy has been demonstrated in Parkinson’s disease (PD). We aimed to investigate, in a cross-sectional manner, whether SFN is overrepresented in PD patien...

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Autores principales:	Mattias Andréasson, Neil Lagali, Reza A. Badian, Tor Paaske Utheim, Fabio Scarpa, Alessia Colonna, Stephan Allgeier, Andreas Bartschat, Bernd Köhler, Ralf Mikut, Klaus-Martin Reichert, Göran Solders, Kristin Samuelsson, Henrik Zetterberg, Kaj Blennow, Per Svenningsson
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/0ebc3b91d1a748528d953d2a27282feb
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spelling	oai:doaj.org-article:0ebc3b91d1a748528d953d2a27282feb2021-12-02T15:13:03ZParkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study10.1038/s41531-020-00148-52373-8057https://doaj.org/article/0ebc3b91d1a748528d953d2a27282feb2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41531-020-00148-5https://doaj.org/toc/2373-8057Abstract Small fiber neuropathy (SFN) has been suggested as a trigger of restless legs syndrome (RLS). An increased prevalence of peripheral neuropathy has been demonstrated in Parkinson’s disease (PD). We aimed to investigate, in a cross-sectional manner, whether SFN is overrepresented in PD patients with concurrent RLS relative to PD patients without RLS, using in vivo corneal confocal microscopy (IVCCM) and quantitative sensory testing (QST) as part of small fiber assessment. Study participants comprised of age- and sex-matched PD patients with (n = 21) and without RLS (n = 21), and controls (n = 13). Diagnosis of RLS was consolidated with the sensory suggested immobilization test. Assessments included nerve conduction studies (NCS), Utah Early Neuropathy Scale (UENS), QST, and IVCCM, with automated determination of corneal nerve fiber length (CNFL) and branch density (CNBD) from wide-area mosaics of the subbasal nerve plexus. Plasma neurofilament light (p-NfL) was determined as a measure of axonal degeneration. No significant differences were found between groups when comparing CNFL (p = 0.81), CNBD (p = 0.92), NCS (p = 0.82), and QST (minimum p = 0.54). UENS scores, however, differed significantly (p = 0.001), with post-hoc pairwise testing revealing higher scores in both PD groups relative to controls (p = 0.018 and p = 0.001). Analysis of all PD patients (n = 42) revealed a correlation between the duration of l-dopa therapy and CNBD (ρ = −0.36, p = 0.022), and p-NfL correlated with UENS (ρ = 0.35, p = 0.026) and NCS (ρ = −0.51, p = 0.001). Small and large fiber neuropathy do not appear to be associated with RLS in PD. Whether peripheral small and/or large fiber pathology associates with central neurodegeneration in PD merits further longitudinal studies.Mattias AndréassonNeil LagaliReza A. BadianTor Paaske UtheimFabio ScarpaAlessia ColonnaStephan AllgeierAndreas BartschatBernd KöhlerRalf MikutKlaus-Martin ReichertGöran SoldersKristin SamuelssonHenrik ZetterbergKaj BlennowPer SvenningssonNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Mattias Andréasson Neil Lagali Reza A. Badian Tor Paaske Utheim Fabio Scarpa Alessia Colonna Stephan Allgeier Andreas Bartschat Bernd Köhler Ralf Mikut Klaus-Martin Reichert Göran Solders Kristin Samuelsson Henrik Zetterberg Kaj Blennow Per Svenningsson Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
description	Abstract Small fiber neuropathy (SFN) has been suggested as a trigger of restless legs syndrome (RLS). An increased prevalence of peripheral neuropathy has been demonstrated in Parkinson’s disease (PD). We aimed to investigate, in a cross-sectional manner, whether SFN is overrepresented in PD patients with concurrent RLS relative to PD patients without RLS, using in vivo corneal confocal microscopy (IVCCM) and quantitative sensory testing (QST) as part of small fiber assessment. Study participants comprised of age- and sex-matched PD patients with (n = 21) and without RLS (n = 21), and controls (n = 13). Diagnosis of RLS was consolidated with the sensory suggested immobilization test. Assessments included nerve conduction studies (NCS), Utah Early Neuropathy Scale (UENS), QST, and IVCCM, with automated determination of corneal nerve fiber length (CNFL) and branch density (CNBD) from wide-area mosaics of the subbasal nerve plexus. Plasma neurofilament light (p-NfL) was determined as a measure of axonal degeneration. No significant differences were found between groups when comparing CNFL (p = 0.81), CNBD (p = 0.92), NCS (p = 0.82), and QST (minimum p = 0.54). UENS scores, however, differed significantly (p = 0.001), with post-hoc pairwise testing revealing higher scores in both PD groups relative to controls (p = 0.018 and p = 0.001). Analysis of all PD patients (n = 42) revealed a correlation between the duration of l-dopa therapy and CNBD (ρ = −0.36, p = 0.022), and p-NfL correlated with UENS (ρ = 0.35, p = 0.026) and NCS (ρ = −0.51, p = 0.001). Small and large fiber neuropathy do not appear to be associated with RLS in PD. Whether peripheral small and/or large fiber pathology associates with central neurodegeneration in PD merits further longitudinal studies.
format	article
author	Mattias Andréasson Neil Lagali Reza A. Badian Tor Paaske Utheim Fabio Scarpa Alessia Colonna Stephan Allgeier Andreas Bartschat Bernd Köhler Ralf Mikut Klaus-Martin Reichert Göran Solders Kristin Samuelsson Henrik Zetterberg Kaj Blennow Per Svenningsson
author_facet	Mattias Andréasson Neil Lagali Reza A. Badian Tor Paaske Utheim Fabio Scarpa Alessia Colonna Stephan Allgeier Andreas Bartschat Bernd Köhler Ralf Mikut Klaus-Martin Reichert Göran Solders Kristin Samuelsson Henrik Zetterberg Kaj Blennow Per Svenningsson
author_sort	Mattias Andréasson
title	Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
title_short	Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
title_full	Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
title_fullStr	Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
title_full_unstemmed	Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
title_sort	parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0ebc3b91d1a748528d953d2a27282feb
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Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

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