Review Highlights Prevalence of Restless Legs Syndrome Among Migraineurs

Prevalence of restless legs syndrome (RLS) is elevated among individuals with migraine according to a systematic review and meta-analysis published in Pain Research and Management.

Migraine is classified as a type of brain disturbance of the subcortical aminergic sensory modulatory systems and can be triggered by a variety of causes such as food, barometric pressure changes, and stress. However, the exact underlying cause of migraine is unknown.

RLS is a movement disorder in which there is a feeling of distress and a tendency to move one’s legs, and in some cases, one’s arms and neck. Similarly, an underlying cause of RLS has not been established, although the syndrome is thought to be associated with iron deficiency in the brain. Kidney failure, pregnancy, anemia, and genetics are also associated with secondary RLS, the researchers wrote. It is estimated RLS affects 2% to 15 % of the population, and that prevalence increases with age.

Both migraine and RLS can negatively impact individuals’ quality of life. Using the databases ScienceDirect, Embase, Scopus, SID, IranDoc, Medline (PubMed), and Google Scholar, the researchers aimed to quantify the overall prevalence of RLS in migraineurs.

Only related cross-sectional studies published between January 2000 and December 2019 in Persian or English were included in the review. To assess the quality of the studies, researchers used the STROBE checklist. The final analysis included 12 articles with a total sample size of 15,196. A meta-analysis found the overall prevalence of RLS in migraineurs was 16.3% (95% CI, 12.6%-20.8%).

Additional findings include:

• The prevalence of RLS in patients with migraine was higher in patients ≥65 years in Turkey (33.8%; 95% CI, 23.4%-64.1%) but lower (8.7%; 95% CI, 7.7%-9.8%) in France
• As sample size increased, the prevalence of RLS in patients with migraine decreased (P < .05)
• As years went on, the prevalence of RLS in patients with migraine increased (P < .05)

The researchers hypothesized that as sample sizes increased, and thus more health individuals entered studies, the incidence of RLS decreased. Similarly, increases and improvements in diagnostic testing may contribute to increased incidence of RLS in more recent studies.

Dopamine chemicals are believed to be involved in the development of RLS while dopaminergic treatments may alleviate symptoms. However, migraine treated with certain therapies such as antiepileptic agents, like topiramate, may also induce RLS.

Studies have also shown that the prevalence of RLS in patients with migraine in Western countries is higher than those in Asian nations, potentially pointing to a genetic factor.

“This study provides a context for further studies on the treatment and impact of different therapies in the RLS population,” the authors concluded. “Future studies may focus on the comparison of the effects of dopaminergic treatments in patients with RLS and migraine.”

Reference

Ghasemi H, Khaledi-Paveh B, Abdi A, et al. The prevalence of restless legs syndrome in patients with migraine: a systematic review and meta-analysis. Pain Res Manag. Published online August 29, 2020. doi:10.1155/2020/2763808