Istradefylline for Restless Legs Syndrome Associated with Parkinson’s Disease

Abstract

Restless legs syndrome (RLS) is the most common movement disorder and is characterized by the feeling of an urgent need to move the legs while lying down or resting. RLS worsens during the evening and at night and is relieved by leg movement.1,2 It is also known that RLS is commonly comorbid with Parkinson’s disease (PD).3 Although the exact pathological mechanism of RLS is unknown, dopaminergic medications for PD, such as levodopa and other dopamine agonists, symptomatically improve RLS as well.4 Istradefylline is a highly selective adenosine A2A receptor antagonist that is thought to modulate the overactivated striatopallidal pathway (indirect pathway) in PD,4 reducing the duration of the ‘‘off’’ state and extending the ‘‘on’’ state without inducing dyskinesia.5 Istradefylline has been recently approved in Japan for the treatment of PD, but, to date, there are no data on the effect of istradefylline on RLS in PD. Here we report the cases of three patients with RLS comorbid with PD who were treated with istradefylline

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