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Zali A, Motavaf M, Safari S, Ebrahimi N, Ghajarzadeh M, Khoshnood RJ, Mirmosayyeb O. The prevalence of restless legs syndrome (RLS) in patients with multiple sclerosis (MS): a systematic review and meta-analysis-an update. Neurol Sci 2023; 44:67-82. [PMID: 36058956 DOI: 10.1007/s10072-022-06364-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/20/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The prevalence of restless legs syndrome (RLS) is reported to vary in patients with multiple sclerosis (MS) in studies which are conducted in different populations. The goal of this systematic review and meta-analysis is to update the prevalence of RLS in MS cases. METHODS We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Google Scholar, and gray literature including references from identified studies and conference abstracts which were published up to June 2021. Data on the total number of participants, first author, country, disease duration, number of controls, mean patient age, male and female numbers, mean EDSS, and number of cases and/or controls with RLS were extracted from the included studies. RESULTS The literature search revealed 855 articles; after deleting duplicates, 530 remained. For the meta-analysis, 75 studies were included (Fig. 1). In six articles, the authors did not differentiate between CIS and MS cases when reporting RLS cases. In total, 15,411 MS/CIS patients were evaluated and 4309 had RLS. The pooled prevalence of RLS was 28% (95% CI: 24-33%). The pooled prevalence of RLS in men was 22% (95% CI: 17-26%), and the pooled prevalence of RLS in women was 30% (95% CI: 25-35%). The pooled prevalence of RLS in controls was 8% (95% CI: 6-10%). CONCLUSION The results of this systematic review and meta-analysis show that the pooled prevalence of RLS is 28% in MS cases and 8%. The pooled prevalence is higher in women than men (30% vs 22%).
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Affiliation(s)
- Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Qods Sq., Building no 1, 4th floor, Tajrish, Tehran, Iran
| | - Mahsa Motavaf
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Qods Sq., Building no 1, 4th floor, Tajrish, Tehran, Iran
| | - Saeid Safari
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Qods Sq., Building no 1, 4th floor, Tajrish, Tehran, Iran.
| | - Narges Ebrahimi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Ghajarzadeh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Jalili Khoshnood
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Qods Sq., Building no 1, 4th floor, Tajrish, Tehran, Iran
| | - Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Schürks M, Bussfeld P. Multiple sclerosis and restless legs syndrome: a systematic review and meta-analysis. Eur J Neurol 2012; 20:605-15. [PMID: 23078359 DOI: 10.1111/j.1468-1331.2012.03873.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 08/17/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Restless legs syndrome (RLS) has been reported to occur more frequently in patients with multiple sclerosis (MS) than in people without MS. METHODS Systematic review and meta-analysis of studies investigating RLS in patients with MS published through April 2012. We calculated the prevalences and 95% confidence intervals (CIs) of RLS in patients with MS and people without MS as well as odds ratios (ORs) and 95% CIs of the association between MS and RLS based on data from the publications. We then calculated pooled effect estimates for the association between MS and RLS. RESULTS We identified 24 studies. RLS prevalence amongst patients with MS ranged from 12.12% to 57.50% and from 2.56% to 18.33% amongst people without MS. Heterogeneity amongst studies was high (RLS prevalence in patients with MS I(2) =94.4%; RLS prevalence amongst people without MS I(2) =82.2%). Hence, we did not pool the prevalence data for meta-analysis. Heterogeneity amongst studies investigating the association between MS and RLS was moderate (I(2) =53.6%). Pooled analysis indicates that MS is associated with a fourfold increased odds for RLS (pooled OR=4.19, 95% CI 3.11-5.66). This association was smaller amongst studies published as full papers (pooled OR=3.94, 95% CI 2.81-5.54) than amongst studies published as abstracts only (pooled OR=6.23, 95% CI 3.25-11.95). CONCLUSION This systematic review indicates that RLS prevalence amongst patients with MS ranges from 12.12% to 57.50% in different populations. Pooled analysis further indicates that the odds of RLS amongst patients with MS are fourfold higher compared to people without MS.
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Affiliation(s)
- M Schürks
- Bayer HealthCare, Leverkusen, Germany.
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