Morbus Parkinson und Restless-legs-Syndrom – ein unterschätztes Problem?

ZUSAMMENFASSUNG

Das idiopathische Parkinson-Syndrom (IPS) gehört zu den häufigsten neurodegenerativen Erkrankungen mit multiplen motorischen und nicht motorischen Symptomen. Schlafstörungen sind das häufigste nicht motorische Symptom bei Parkinson [1]. Das Restless-legs-Syndrom (RLS) ist eine häufige, schlafassoziierte Bewegungsstörung. Eine Metaanalyse hat eine erhöhte Prävalenz von RLS bei IPS-Patienten im Vergleich zu gesunden Kontrollen gezeigt [3], [7], [9], [12], [21]. Es gibt mittlerweile viele Hinweise, dass die IPS-RLS-Gruppe einen längeren Krankheitsverlauf, ein fortgeschrittenes Krankheitsstadium, höhere Scores motorischer Symptome, Depression, Angst, Schlafstörungen, Fatigue und Apathie sowie ein reduziertes Transferrin und Ferritin im Serum aufweisen [35]. Die dopaminerge Medikation ist die effektivste Therapie des IPS und hat therapeutische Effekte auf das RLS. Wir vermuten aber auch, dass eine dopaminerge Langzeittherapie ein Risiko für die Entwicklung einer RLS-Augmentation darstellt [9]. Dabei sollte immer an einen möglichen Eisenmangel gedacht werden. Die tiefe Hirnstimulation, als eine mögliche alternative Therapie, scheint bei Parkinson-Patienten mit RLS die Schlafqualität zu verbessern [24], [32].

ABSTRACT

Parkinson’s disease (PD) is one of the most common neurodegenerative syndromes with multiple motor and nonmotor symptoms. Sleep disorders are the most frequent among PD’s nonmotor symptoms [1]. The restless legs syndrome (RLS) is a common sleep-related movement disorder. A meta-analysis showed an increased prevalence of RLS in PD patients compared with healthy controls [3], [7], [9], [12], [21]. By now there are many indications that the PD-RLS group had longer duration, higher stage and scores of motor symptoms, depression, anxiety, sleep disorders, fatigue and apathy, and decreased transferrin und ferritin levels in serum [35]. Dopaminergic medication is the most effective treatment for PD and has a therapeutic effect also on RLS [34]. But we also suspect that long-term dopaminergic therapy is a risk factor for developing augmentation of RLS [9]. A possible iron deficiency should always be considered. The DBS as a possible alternative therapy appears to improve the sleep quality in PD patients with RLS [24], [32].

Schlüsselwörter

Idiopathisches Parkinson-Syndrom - Restless-legs-Syndrom - klinische Symptomatik - Eisenstoffwechsel - Pharmakotherapie

Key words

Parkinson’s disease - restless legs syndrome - clinical features - iron metabolism - pharmacotherapy

Publikationsverlauf

Artikel online veröffentlicht:
05. Oktober 2021

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