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Restless legs syndrome may be associated with freezing of gait, start hesitation and falls in Parkinson’s disease

M. Isayan, H. Hovakimyan, S. Khachatryan, Z. Tavadyan (Yerevan, Armenia)

Meeting: 2023 International Congress

Abstract Number: 935

Keywords: Pain, Parkinson’s, Restless legs syndrome(RLS): Clinical features

Category: Restless Legs Syndrome and Other Sleep Disorders

Objective: We aimed to assess the association between RLS and freezing of gait, start hesitation and falls.

Background: Parkinson’s disease (PD) is a neurodegenerative disease accompanied by many comorbidities. Restless legs syndrome (RLS) is a sleep-related movement disorder that can be seen in patients with PD, as well as in the general population.

Method: We involved PD patients in Hoehn and Yahr stages 1-4 with or without RLS who did not have significant medical comorbidities. PD patients were enrolled at a tertiary movement disorders center in Armenia. The diagnosis of PD was established according to the UK PDS Brain Bank criteria. Diagnosis of RLS was based on International RLS Study Group criteria. PD patients underwent a clinical interview, UPDRS scoring and were specifically assessed for falls, start hesitation, and freezing of gait. We compared the abovementioned symptoms in a group of patients with RLS and a group of patients with pain. Chi-square analysis was performed.

Results: We overall involved 91 PD patients (mean age – 62.4, females – 48.4%), including 19 PD patients with RLS (20.9%). PD patients with falls showed higher prevalence of RLS (40% vs 16.2%, p<0.05). Start hesitation was more frequently associated with RLS (33.3% vs 8.3%, p<0.05). RLS symptoms were reported more in PD patients with freezing of gait (36.4% vs 7.5%, p<0.05). In comparison to the abovementioned findings, falls, start hesitation and gait freezing symptoms did not show any significant differences in regards to pain: falls/no falls – 82.4% vs 65.3%; start hesitation/no start hesitation – 72% vs 65.9%; gait freezing/no freezing – 66.7% vs 72.2% (p>0.05).

Conclusion: We found an interesting association between RLS and freezing of gait, start hesitation and falls in patients with PD, which was not observed while the same comparison was performed for pain. This link may be explained with higher prevalence of RLS in patients with advanced PD, with higher probability of gait problems and longer exposure to levodopa. On the other hand, a specific causative association could be the explanation. Hence, this study adds to the knowledge of the sensory symptom burden in PD. Thus, the importance of potential role of RLS in manifestations of advanced motor symptoms in PD should not be overlooked.

To cite this abstract in AMA style:

M. Isayan, H. Hovakimyan, S. Khachatryan, Z. Tavadyan. Restless legs syndrome may be associated with freezing of gait, start hesitation and falls in Parkinson’s disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/restless-legs-syndrome-may-be-associated-with-freezing-of-gait-start-hesitation-and-falls-in-parkinsons-disease/. Accessed May 24, 2025.
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