Validation of the “L‐DOPA test” for diagnosis of restless legs syndrome
Identifieur interne : 000A43 ( Istex/Corpus ); précédent : 000A42; suivant : 000A44Validation of the “L‐DOPA test” for diagnosis of restless legs syndrome
Auteurs : Karin Stiasny-Kolster ; Ralf Kohnen ; Jens Carsten Möller ; Claudia Trenkwalder ; Wolfgang H. OertelSource :
- Movement Disorders [ 0885-3185 ] ; 2006-09.
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- KwdEn :
Abstract
We developed and validated a standardized test procedure to evaluate the accuracy of the supportive diagnostic criterion “response to dopaminergic treatment” in restless legs syndrome (RLS). Forty‐eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non‐RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic L‐DOPA test at home, which consisted in the application of one single dose of 100/25 mg L‐DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15‐minute intervals after, drug intake, the patients rated the severity of the “symptoms in the legs” and the “urge to move the legs” using a 100‐mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% (“symptoms in the legs”) and 80% (“urge to move the legs”) with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the L‐DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the L‐DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.20969
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Forty‐eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non‐RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic L‐DOPA test at home, which consisted in the application of one single dose of 100/25 mg L‐DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15‐minute intervals after, drug intake, the patients rated the severity of the “symptoms in the legs” and the “urge to move the legs” using a 100‐mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% (“symptoms in the legs”) and 80% (“urge to move the legs”) with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the L‐DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the L‐DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Karin Stiasny‐Kolster MD</name><affiliations><json:string>Department of Neurology, Center of Nervous Diseases, Philipps‐University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Ralf Kohnen PhD</name><affiliations><json:string>IMEREM Institute for Medical Research Management and Biometrics, Nuremberg, Germany</json:string></affiliations></json:item><json:item><name>Jens Carsten Möller MD</name><affiliations><json:string>Department of Neurology, Center of Nervous Diseases, Philipps‐University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Claudia Trenkwalder MD</name><affiliations><json:string>Paracelsus Elena‐Klinik, Center of Parkinsonism and Movement Disorders, Kassel, Germany</json:string></affiliations></json:item><json:item><name>Wolfgang H. 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Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. 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Forty‐eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non‐RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic L‐DOPA test at home, which consisted in the application of one single dose of 100/25 mg L‐DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15‐minute intervals after, drug intake, the patients rated the severity of the “symptoms in the legs” and the “urge to move the legs” using a 100‐mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% (“symptoms in the legs”) and 80% (“urge to move the legs”) with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the L‐DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the L‐DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>restless legs syndrome</term></item><item><term>diagnosis</term></item><item><term>L‐DOPA test</term></item><item><term>polysomnography</term></item><item><term>periodic leg movements (PLM)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-08-03">Received</change><change when="2006-01-15">Registration</change><change when="2006-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/5DA37515A5E9A1231E330A91AF11EF1EA4E7746B/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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Forty‐eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non‐RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic <sc>L</sc>‐DOPA test at home, which consisted in the application of one single dose of 100/25 mg <sc>L</sc>‐DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15‐minute intervals after, drug intake, the patients rated the severity of the “symptoms in the legs” and the “urge to move the legs” using a 100‐mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% (“symptoms in the legs”) and 80% (“urge to move the legs”) with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the <sc>L</sc>‐DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the <sc>L</sc>‐DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 4-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Validation of the “L‐DOPA test” for diagnosis of restless legs syndrome</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>L‐DOPA Test in RLS</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Validation of the “</title></titleInfo><name type="personal"><namePart type="given">Karin</namePart><namePart type="family">Stiasny‐Kolster</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Center of Nervous Diseases, Philipps‐University, Marburg, Germany</affiliation><description>Correspondence: Department of Neurology, Center of Nervous Diseases, Rudolf‐Bultmann‐Strasse 8, D‐35033 Marburg, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ralf</namePart><namePart type="family">Kohnen</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>IMEREM Institute for Medical Research Management and Biometrics, Nuremberg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jens</namePart><namePart type="family">Carsten Möller</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Center of Nervous Diseases, Philipps‐University, Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claudia</namePart><namePart type="family">Trenkwalder</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Paracelsus Elena‐Klinik, Center of Parkinsonism and Movement Disorders, Kassel, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wolfgang H.</namePart><namePart type="family">Oertel</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Center of Nervous Diseases, Philipps‐University, Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-09</dateIssued><dateCaptured encoding="w3cdtf">2005-08-03</dateCaptured><dateValid encoding="w3cdtf">2006-01-15</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent><extent unit="references">25</extent><extent unit="words">4680</extent></physicalDescription><abstract lang="en">We developed and validated a standardized test procedure to evaluate the accuracy of the supportive diagnostic criterion “response to dopaminergic treatment” in restless legs syndrome (RLS). Forty‐eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non‐RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic L‐DOPA test at home, which consisted in the application of one single dose of 100/25 mg L‐DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15‐minute intervals after, drug intake, the patients rated the severity of the “symptoms in the legs” and the “urge to move the legs” using a 100‐mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% (“symptoms in the legs”) and 80% (“urge to move the legs”) with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the L‐DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the L‐DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>restless legs syndrome</topic><topic>diagnosis</topic><topic>L‐DOPA test</topic><topic>polysomnography</topic><topic>periodic leg movements (PLM)</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1333</start><end>1339</end><total>7</total></extent></part></relatedItem><identifier type="istex">5DA37515A5E9A1231E330A91AF11EF1EA4E7746B</identifier><identifier type="DOI">10.1002/mds.20969</identifier><identifier type="ArticleID">MDS20969</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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