Xiao-Ying Zhu1, Ting-Ting Wu1, Hong-Ming Wang2, Ling-Yan Ni1, Xuan Li1, Ye Liu1, Xiao-Jin Zhang1, Ya-Jing Chen1, Xin-Xin Cui1, William G Ondo3, Yun-Cheng Wu4. 1. Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. 2. Department of Clinical Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. 3. Methodist Neurological Institute, Weill Cornell Medical School, Houston, TX, USA. 4. Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. Electronic address: yunchw@medmail.com.cn.
Abstract
BACKGROUND: The clinical spectrum of restless legs syndrome (RLS) has not been described in a Chinese population. We aim to evaluate the detailed clinical profile in a cohort of unselected RLS patients in China. METHODS: We enrolled RLS patients continuously according to the diagnostic criteria. Laboratory examinations were performed to exclude mimics and notable comorbidities. RESULTS: A total of 359 patients with RLS were enrolled. RLS symptoms were mostly symmetrical (65.2%), and purely unilateral RLS was not common (5.6%); however, unilateral dominant RLS was relatively more common. Only 1.1% of RLS patients reported no unpleasant sensations in the legs. The largest proportion of RLS patients described their uncomfortable sensation as indescribable (43.5%) and reported soreness (40.4%). In all, 8.9% of RLS patients described their abnormal sensation as painful, and 34.5% of RLS patients reported their symptoms fluctuated with seasonal trends. This population had a higher likelihood of an RLS family history. RLS patients with summer exacerbation had a younger age at RLS onset and longer disease duration (p < 0.01). Iron deficiency without anemia was common in Chinese RLS patients. Early-onset RLS patients were more likely to have a positive family history (p < 0.01), more summer worsening of symptoms (p < 0.01) and more severely disturbed peripheral iron status (p < 0.01) when compared to late-onset RLS patients. CONCLUSION: The subjective description is somewhat different, with Chinese RLS patients reporting less pain and more soreness than patients from Western countries. Seasonal fluctuation and iron deficiency without anemia are frequently seen in Chinese RLS patients and predict some other features. Differentiating these various subtypes can facilitate optimal management.
BACKGROUND: The clinical spectrum of restless legs syndrome (RLS) has not been described in a Chinese population. We aim to evaluate the detailed clinical profile in a cohort of unselected RLSpatients in China. METHODS: We enrolled RLSpatients continuously according to the diagnostic criteria. Laboratory examinations were performed to exclude mimics and notable comorbidities. RESULTS: A total of 359 patients with RLS were enrolled. RLS symptoms were mostly symmetrical (65.2%), and purely unilateral RLS was not common (5.6%); however, unilateral dominant RLS was relatively more common. Only 1.1% of RLSpatients reported no unpleasant sensations in the legs. The largest proportion of RLSpatients described their uncomfortable sensation as indescribable (43.5%) and reported soreness (40.4%). In all, 8.9% of RLSpatients described their abnormal sensation as painful, and 34.5% of RLSpatients reported their symptoms fluctuated with seasonal trends. This population had a higher likelihood of an RLS family history. RLSpatients with summer exacerbation had a younger age at RLS onset and longer disease duration (p < 0.01). Iron deficiency without anemia was common in Chinese RLSpatients. Early-onset RLSpatients were more likely to have a positive family history (p < 0.01), more summer worsening of symptoms (p < 0.01) and more severely disturbed peripheral iron status (p < 0.01) when compared to late-onset RLSpatients. CONCLUSION: The subjective description is somewhat different, with Chinese RLSpatients reporting less pain and more soreness than patients from Western countries. Seasonal fluctuation and iron deficiency without anemia are frequently seen in Chinese RLSpatients and predict some other features. Differentiating these various subtypes can facilitate optimal management.