Circulating levels of cytokines are increased in restless legs syndrome
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NEUROLOGY • ORIGINAL ARTICLE
Circulating levels of cytokines are increased in restless legs syndrome Ferda Ilgen Uslu 1
&
Ervanur Demir 2 & Eray Metin Güler 3
&
Abdürahim Koçyiğit 3
Received: 29 July 2020 / Revised: 4 October 2020 / Accepted: 7 October 2020 # Springer Nature Switzerland AG 2020
Abstract Background Restless legs syndrome [RLS] is known as a disease of iron and dopaminergic dysregulation but inflammatory processes might also have a role in the pathogenesis. In this study, we compared the circulating levels of hsCRP, IL-1β, IL-6, and TNF-α in patients with primary restless legs syndrome [RLS] and healthy control subjects. Methods We prospectively included 29 patients with primary RLS and 65 healthy controls [HC], all age-sex matched. The diagnosis of RLS was established using international guidelines. IRLSSG Severity Scale was used to evaluate the severity of RLS. Plasma levels of hsCRP, IL-1β, IL-6, and TNF-α were measured in all participants. Results The mean age of patients was 37.8 ± 11.3 and 52% of RLS group were women. Serum IL-1β, IL-6, and TNF-α levels of the patient group were statistically significantly higher compared to HC [p < 0.001 for all variables]. Plasma levels of hsCRP did not differ between groups. There were 8 patients with mild RLS [28%], 13 patients with moderate RLS [45%], and 8 patients with severe RLS [28%]. Only IL-6 values were significantly different between the groups. In the severe group, the value of IL-6 was significantly higher than in the other groups [p: 0.03]. Conclusion These results showing higher circulating levels of inflammatory cytokines in patients with RLS support the notion that inflammation may be involved in the pathogenesis of primary RLS. However, it is necessary to perform further studies to determine if this finding is a cause or an effect. Keywords Restless legs syndrome . Interleukin-6 . Interleukin-1β . TNF-α
Introduction Restless legs syndrome [RLS] is a movement disorder which causes a persistent urge to move the legs during the night and interferes with sleep [1]. RLS affects about 5–10% of the
* Ferda Ilgen Uslu [email protected] Ervanur Demir [email protected] Eray Metin Güler [email protected] Abdürahim Koçyiğit [email protected] 1
Neurology Department, Bezmialem Vakıf University Medical Faculty, İstanbul, Turkey
2
Bezmialem Vakıf University Medical Faculty, İstanbul, Turkey
3
Biochemistry Department, Bezmialem Vakıf University Medical Faculty, İstanbul, Turkey
adults in North America and Western Europe [2]. Although RLS may occur secondarily to some comorbid conditions such as iron deficiency, uremia, pregnancy, and spinal cord or peripheral nerve injuries, the etiology of “primary RLS” is still not well known [3]. Iron and dopaminergic systems are the most extensively studied systems for understanding the underlying mechanism of RLS [4]. However, other potential pathways might be involved in the pathophysiological process in relation to or separately from these systems. For instance, higher prevalence of RL
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