Introduction and objective: Depending on the methodology used, the prevalence of restless legs syndrome (RLS) in people with multiple sclerosis (PwMS) ranges from 13 to 65%. This study aimed to evaluate the prevalence of RLS in PwMS using a case-control design, with each case confirmed by a sleep disorder specialist.
Methods: Prevalence of RLS was analyzed in a hospital cohort of 440 PwMS and 241 age- and sex-matched control subjects. Cases were identified through two interviews. First, participants answered to a structured questionnaire, and second, those who met the criteria for any cardinal RLS symptoms were interviewed by a sleep disorder specialist to confirm the diagnosis. Multivariate regression was used to analyze the clinical and radiological characteristics of MS associated with RLS.
Results: Of the 86 PwMS who tested positive for RLS using the questionnaire, 67 were diagnosed by a sleep specialist, corresponding to a prevalence of 15.23% (95% CI 11.80-19.34) compared to 19.55% (95% CI 15.63-24.14) based solely on the questionnaire (false positive: 22.09%). PwMS were twice as likely to suffer from this syndrome as the control group (OR 2.148, 95% CI 1.218-3.788, p = 0.008). Family history of RLS (OR 5.291, 95% CI 2.407-11.629, p < 0.0001) and pyramidal tract involvement (OR 4.208 95% CI 1.940-9.128, p < 0.0001) were the only factors associated with RLS.
Conclusion: PwMS are twice as likely to develop RLS as the general population. Pyramidal tract involvement appears to be a risk factor for developing RLS in this disease.
Keywords: Associated factors; Diagnosis confirmation; Multiple sclerosis; Prevalence; Restless legs syndrome.
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