Validation of the "L-DOPA test" for diagnosis of restless legs syndrome
Identifieur interne : 001849 ( PascalFrancis/Checkpoint ); précédent : 001848; suivant : 001850Validation of the "L-DOPA test" for diagnosis of restless legs syndrome
Auteurs : Karin Stiasny-Kolster [Allemagne] ; Ralf Kohnen [Allemagne] ; Jens Carsten Moller [Allemagne] ; Claudia Trenkwalder [Allemagne] ; Wolfgang H. Oertel [Allemagne]Source :
- Movement disorders [ 0885-3185 ] ; 2006.
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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.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Validation of the "L-DOPA test" for diagnosis of restless legs syndrome</title><author><name sortKey="Stiasny Kolster, Karin" sort="Stiasny Kolster, Karin" uniqKey="Stiasny Kolster K" first="Karin" last="Stiasny-Kolster">Karin Stiasny-Kolster</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, Center of Nervous Diseases, Philipps-University</s1><s2>Marburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author><author><name sortKey="Kohnen, Ralf" sort="Kohnen, Ralf" uniqKey="Kohnen R" first="Ralf" last="Kohnen">Ralf Kohnen</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>IMEREM Institute for Medical Research Management and Biometrics</s1><s2>Nuremberg</s2><s3>DEU</s3><sZ>2 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Nuremberg</wicri:noRegion><wicri:noRegion>IMEREM Institute for Medical Research Management and Biometrics</wicri:noRegion><wicri:noRegion>IMEREM Institute for Medical Research Management and Biometrics</wicri:noRegion></affiliation></author><author><name sortKey="Moller, Jens Carsten" sort="Moller, Jens Carsten" uniqKey="Moller J" first="Jens Carsten" last="Moller">Jens Carsten Moller</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, Center of Nervous Diseases, Philipps-University</s1><s2>Marburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author><author><name sortKey="Trenkwalder, Claudia" sort="Trenkwalder, Claudia" uniqKey="Trenkwalder C" first="Claudia" last="Trenkwalder">Claudia Trenkwalder</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Paracelsus Elena-Klinik, Center of Parkinsonism and Movement Disorders</s1><s2>Kassel</s2><s3>DEU</s3><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Kassel</region><settlement type="city">Cassel (Hesse)</settlement></placeName></affiliation></author><author><name sortKey="Oertel, Wolfgang H" sort="Oertel, Wolfgang H" uniqKey="Oertel W" first="Wolfgang H." last="Oertel">Wolfgang H. 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Oertel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, Center of Nervous Diseases, Philipps-University</s1><s2>Marburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Diagnosis</term><term>Levodopa</term><term>Nervous system diseases</term><term>Peridoc leg movement</term><term>Polysomnography</term><term>Restless legs syndrome</term><term>Test validation</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Impatience membre inférieur syndrome</term><term>Validation test</term><term>Lévodopa</term><term>Diagnostic</term><term>Polysomnographie</term><term>Mouvement périodique des jambes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml: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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>21</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Validation of the "L-DOPA test" for diagnosis of restless legs syndrome</s1></fA08><fA11 i1="01" i2="1"><s1>STIASNY-KOLSTER (Karin)</s1></fA11><fA11 i1="02" i2="1"><s1>KOHNEN (Ralf)</s1></fA11><fA11 i1="03" i2="1"><s1>MOLLER (Jens Carsten)</s1></fA11><fA11 i1="04" i2="1"><s1>TRENKWALDER (Claudia)</s1></fA11><fA11 i1="05" i2="1"><s1>OERTEL (Wolfgang H.)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Center of Nervous Diseases, Philipps-University</s1><s2>Marburg</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="02"><s1>IMEREM Institute for Medical Research Management and Biometrics</s1><s2>Nuremberg</s2><s3>DEU</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Paracelsus Elena-Klinik, Center of Parkinsonism and Movement Disorders</s1><s2>Kassel</s2><s3>DEU</s3><sZ>4 aut.</sZ></fA14><fA20><s1>1333-1339</s1></fA20><fA21><s1>2006</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000158780860050</s5></fA43><fA44><s0>0000</s0><s1>© 2006 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>25 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>06-0518083</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>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. 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Oertel</name><name sortKey="Trenkwalder, Claudia" sort="Trenkwalder, Claudia" uniqKey="Trenkwalder C" first="Claudia" last="Trenkwalder">Claudia Trenkwalder</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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