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Executive Dysfunction in Restless Legs Syndrome: Clinical Correlates and Outcome After Therapeutic Management

Not Applicable
Recruiting
Conditions
Restless Legs Syndrome
Interventions
Other: Polysomnography
Other: Clinical Scales
Other: Assessment of executive functions
Other: Medical consultation
Registration Number
NCT01823354
Lead Sponsor
University Hospital, Montpellier
Brief Summary

Restless leg syndrome (RLS) is a common neurological disorder whose diagnosis is only clinical. The efficacy of dopaminergic agents in improvement of sensorimotor symptoms advance the hypothesis that altered dopaminergic transmission is at the origin of this condition. RLS usually leads to a sleep fragmentation, which induces sometimes severe insomnia most often associated, in clinical practice, to a cognitive complaint (attentional in nature). Executive functions in which dopaminergic transmission is heavily involved refer to a set of complex functions. At least three of them should be considered during their evaluation (ie flexibility, inhibition, and the updating of working memory). These functions are among the targets of the alteration of the quality and quantity of sleep. The few studies that have focused on the study of the integrity of executive functions in RLS have discordant results. The lack of control of key variables in the assessment of executive functioning (ie intellectual performance, depressive symptomatology, generalized slowing in information processing) and the lack of reference in the theoretical approach in executive functions are certainly the two main reasons. Moreover, the question of polysomnographic correlates and the reversibility of these cognitive abnormalities after pharmacological management of RLS remains unanswered today.

The main objective of this study is to compare the executive performance of untreated RLS patients with a group of matched controls.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
176
Inclusion Criteria
  • Non-specific criteria (patients and controls)

    • Age: 18 to 70 years old
    • Fluency in French (written and oral);
    • intellectual performance within the normal range (f-NART> 84)
    • Subject has signed and returned to the investigator a copy of the signed informed consent; .Affiliated to a social security scheme.
  • Specific criteria patients

    • Response to the diagnostic criteria established by the standards of the ICSD-II (2005) and IRLS Study Group (2003) with a severity scale listed at least 21 (score at least severe);
    • MPMS score> 10 / h; .ferritin > 50 ng/ml.
Exclusion Criteria
  • Exclusion criteria (patients and controls)

    • Taking any psychotropic medication within 15 days prior to polysomnography (except for patients on dopamine agonist reassessed at 6 months follow-up);
    • Pregnant and lactating women;
    • Pneumologic affection
    • Night shift;
    • Apnea-hypopnea index > 15; .Major subjects protected by the law, under guardianship.
  • Exclusion criteria (controls)

    • Neurological or psychiatric current and/or past;
    • MPMS score> 10 / h; .Subject currently participating in another clinical research project prohibiting joint participation in another biomedical research, or who are in a period of exclusion or who have already received the maximum legal compensation for stresses in the year.
  • Exclusion criteria (patients)

    • Presence of other neurological conditions present and / or a psychiatric disorder (other than a mood disorder and / or anxiety); .RLS patients previously treated with a dopamine agonist who has not stopped treatment at least 15 days before the start of the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PatientsClinical ScalesPolysomnography, Assessment of executive functions, Clinical scales, Medical consultation
PatientsPolysomnographyPolysomnography, Assessment of executive functions, Clinical scales, Medical consultation
ControlsMedical consultationPolysomnography, Assessment of executive functions, Clinical scales Medical consultation
ControlsPolysomnographyPolysomnography, Assessment of executive functions, Clinical scales Medical consultation
PatientsAssessment of executive functionsPolysomnography, Assessment of executive functions, Clinical scales, Medical consultation
PatientsMedical consultationPolysomnography, Assessment of executive functions, Clinical scales, Medical consultation
ControlsClinical ScalesPolysomnography, Assessment of executive functions, Clinical scales Medical consultation
ControlsAssessment of executive functionsPolysomnography, Assessment of executive functions, Clinical scales Medical consultation
Primary Outcome Measures
NameTimeMethod
Comparison of the Verbal fluency test between untreated RLS patients and control subjectsDay 0

Number of correct words (without repetitions and intrusions) provided by the subject in each condition.

Secondary Outcome Measures
NameTimeMethod
Assessment of executive functions (composite criteria)Day 180

* Trail Making Test GREFEX

* Sroop Test GREFEX

* Wisconsin Card Sorting Test

* Phasic alertness TAP

* Working memory TAP

* Flexibility TAP

* Go / no go TAP

* Score of Reached Executive Severity

Change of the sleep fragmentation at day 180 (composite criteria)Day 0 and Day 180

The severity of sleep fragmentation is determined by these parameters:

* Total time asleep in minutes.

* Percentage of sleep efficiency.

* Ensure intra-sleep.

* Index of arousals / hour of sleep.

* Index of periodic movements per hour of sleep associated with arousal

* Index of arousal.

Change of the Verbal fluency test after dopamin agonist treatment in RLS patientsDay 0 and Day 180

Number of correct words (without repetitions and intrusions) provided by the subject in each condition.

Change of the Clinical Scales at day 180 (composite criteria)Day 0 and day180

* Index of Restless Legs Syndrome Severity

* Index of insomnia Severity

* Beck's Inventory of Depression

* Anxiety Inventory: State-Trait, form Y

Trial Locations

Locations (2)

UH Montpellier

🇫🇷

Montpellier, France

UH Nîmes

🇫🇷

Nîmes, France

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