The relationship with restless legs syndrome, fibromyalgia, and depressive symptoms in migraine patients

DOI: https://doi.org/10.1007/s10072- 018- 3438- 7

Abstract-Summary We aimed to investigate restless legs syndrome, depression, frequency of fibromy- algia and possible causes of its frequencies, and the relationships among these syn- ergies and migraine’s prodrome, aura, pain, and postdrome symptoms in patients with migraine.

The mean age of the migraine patients with restless legs syndrome was also

higher, and this group had migraine headache for a longer time.

2.3 Comorbidities

359

There was a statistically significant difference with regard to only generalized anxiety and traveler’s distress, which were features of the migraine, between migraine patients with and without restless legs syndrome.

Restless legs syndrome was more common in migraine patients with and without

aura and in those with nonspecific white matter lesions in the cranial MRI.

The greater frequency of restless legs syndrome, depressive symptoms, and fibromyalgia in the patients with migraine supports the role of dopamine, which is common to all three disorders.

Extended: We aimed to investigate frequencies of restless legs syndrome, depres- sive symptoms, fibromyalgia, and possible causes of these frequencies in patients with migraine and to analyze the relationships among these associations with symp- toms of prodrome, aura, pain, and postdrome.

The mean age of migraine patients with RLS in our study was higher and the

onset of their headache was longer.

There was a significant difference between the patient and control groups with

respect to the frequency of RLS (p = 0.0001).

We found a 33% prevalence of RLS in the migraine group and 9.5% in the con-

trol group.

The greater frequencies of RLS, fibromyalgia, and depressive symptoms in migraine patients support dopamine’s role, which is common to all three disorders.

Introduction That there is a relationship between the symptoms of prodrome, pain, postdrome in migraine, and the activation of dopaminergic (DA) system.

The latest pharmacological findings support this theory, and central dopaminer-

gic and increased peripheral receptor sensitivity are specific features of migraine.

Increased depression frequency is also associated with both migraine and fibro-

myalgia [526].

Few studies have examined the RLS frequency in patients with migraine. A single case-control study carried out by Rhode and others reported that RLS frequency was significantly higher in migraine patients than that of control sub- jects [527].

We aimed to investigate frequencies of restless legs syndrome, depressive symp- toms, fibromyalgia, and possible causes of these frequencies in patients with migraine and to analyze the relationships among these associations with symptoms of prodrome, aura, pain, and postdrome.

Materials and Methods The study consisted of 200 patients with migraine and was previously or for the first time diagnosed with migraine according to IHS classification criteria [528], and 200 healthy volunteers including health staff or patients’ companions.

In all patients, onset time of symptoms, first complaint, time of making diagno- sis, frequency of daily or weekly attacks, family history of migraine, and patients’ other diseases were also recorded.

360

2 Mechanisms

The patient and control subjects were questioned with respect to clinical symp- toms of RLS based on the criteria of the International Restless Leg Syndrome Study Group (IRLSSG) [529].

All participants were also questioned regarding the risk factors (polyneuropathy, iron deficiency anemia, diabetes mellitus, hypothyroidism, uremia, gastrectomy, cancer, folate deficiency, chronic obstructive lung disease, Parkinson’s disease, lumbosacral radiculopathy, peripheral vascular diseases, rheumatoid arthritis, and use of caffeine, neuroleptics, narcotics, sedatives, lithium, calcium, and antago- nists), family history, and onset of complaints and whether they received any treatment.

Statistical Analyses A comparison of categorical variables between the two groups was made by the chi- square test (Fisher’s exact test was used in cases when the expected variables were below 5 in the 2 × 2 type tables).

A comparison of continuous variables between the two groups was made by the independent two-sample t test since the continuous variables used in the study showed normal variability in terms of Shapiro-Wilks test for normality.

Continuous variables were expressed as the arithmetic means and the standard

deviation (SD).

Results There was a significant difference between the patient and control groups with respect to the frequency of RLS (p = 0.0001).

There was no statistically significant difference between the migraine and con-

trol groups on the basis of average of family history of RLS (p = 0.773).

Fourteen (21.2%) of the 66 migraine patients with RLS and 5 (26.5%) of the 19

RLS patients in the control group had at least one of the risk factors for RLS.

No statistically significant difference regarding the risk factors for RLS between

the migraine and control groups (p = 0.638) was observed.

Concerning migraine severity scores of the patients with RLS in the migraine (15.44 ± 4.08) and control (14.89 ± 4.36) groups (p = 0.615), there was no statisti- cally meaningful difference.

Discussion A single case-control study that investigated the relationship between migraine and RLS determined that life-long RLS prevalence in migraine patients was 17.3% and that of the control group was 5.6% [527].

Of Walente and others, RLS was found in 29/180 (16.1%) migraine patients and

11/180 (6.1%) controls [530].

The greater frequencies of RLS, fibromyalgia, and depressive symptoms in migraine patients support dopamine’s role, which is common to all three disorders. The mean age of migraine patients with RLS in our study was higher and the

onset of their headache was longer.

Similar to our study, Rhode and others reported that migraine patients with RLS

were older and had longer onset of headache [527].

2.3 Comorbidities

361

Frequencies of RLS, fibromyalgia, and depressive symptoms in the patients with

migraine have increased.

Acknowledgement A machine generated summary based on the work of Akdag Uzun, Zehra; Kurt, Semiha; Karaer Unaldi, Hatice. 2018 in Neurological Sciences.

Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study