Neurological Sciences

, 29:166 | Cite as

High prevalence of Dopaminergic Premonitory Symptoms in migraine patients with Restless Legs Syndrome: a pathogenetic link?

  • Daniela Cologno
  • Giulio Cicarelli
  • Vittorio Petretta
  • Florindo d’Onofrio
  • Gennaro Bussone
Oral Communication


In order to assess the prevalence of Dopaminergic Premonitory Symptoms (DPS) in migraine patients with Restless Legs Syndrome (RLS), we chose migraine patients from a large Italian clinical headache population previously investigated for an association between primary headaches and RLS. We evaluated a total sample of 164 patients with migraine, in particular 114 with migraine without aura (MO), 10 with migraine with aura (MA) and 40 with MO and MA in various combinations between them or with episodic tension-type headache (ETTH), defined as a “mixed group”. About 20% of all migraine patients referred at least one of the following DPS: yawning, nausea, somnolence or food craving, confirming data already indicated in the literature. Among migraine patients with RLS (25.6%), DPS were referred from about half of the patients (47.6%) compared to those without RLS (47.6% vs. 13.1%; p<0.001). Based on migraine subtype, patients with MO referred DPS (26.3%) more frequently compared to the MA group and “mixed group” (12.0%, p<0.05), particularly in the presence of RLS (63.0% vs. 20.0%, p<0.01). No statistical differences were found between clinical and demographic data of the subgroups or related to medical conditions investigated (anxiety, depression, sleep disorders, body mass index). It is interesting that the chances of having RLS in migraine patients were more than 5 times higher in the presence of DPS. These results could support a hypothetical dopaminergic imbalance in RLS and migraine, as the dopamine is involved in the pathogenesis of both disorders and it is responsible for the migraine DPS reported above.


Migraine Premonitory symptoms Dopamine Restless legs syndrome 


  1. 1.
    Rossi P, Ambrosini A, Buzzi MG (2005) Prodromes and predictors of migraine attack. Funct Neurol 20:185–191PubMedGoogle Scholar
  2. 2.
    Buzzi MG, Cologno D, Formisano R, Rossi P (2005) Prodromes and the early phase of the migraine attack: therapeutic relevance. Funct Neurol 20:179–183PubMedGoogle Scholar
  3. 3.
    Schoonman GG, Evers DJ, Terwindt GM et al (2006) The prevalence of premonitory symptoms in migraine: a questionnaire study in 461 patients. Cephalalgia 26:1209–1213PubMedCrossRefGoogle Scholar
  4. 4.
    Quintela E, Castillo J, Muñoz P, Pascual J (2006) Premonitory and resolution symptoms in migraine: a prospective study in 100 unselected patients. Cephalalgia 26:1051–1060PubMedCrossRefGoogle Scholar
  5. 5.
    Kelman L (2004) The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache 44:865–872PubMedCrossRefGoogle Scholar
  6. 6.
    Rhode AM, Hösing VG, Happe S et al (2007) Comorbidity of migraine and restless legs syndrome — a case-control study. Cephalalgia 27:1255–1260PubMedCrossRefGoogle Scholar
  7. 7.
    d’Onofrio F, Bussone G, Cologno D et al (2008) Restless legs syndrome and primary headaches: a clinical study. Neurol Sci, in press Google Scholar
  8. 8.
    Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. Cephalalgia 24 [Suppl 1]:9–160Google Scholar
  9. 9.
    Allen RP, Hening WA, Montplaisir J et al (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119PubMedCrossRefGoogle Scholar
  10. 10.
    Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the Beck Depression Inventory. Twenty-five years of evaluation. Clin Psychol Rev 8:77–100CrossRefGoogle Scholar
  11. 11.
    Hamilton M (1960) A rating scale for anxiety. J Neurol Neurosurg Psychiatry 23:56–62PubMedCrossRefGoogle Scholar
  12. 12.
    Allen R (2004) Dopamine and iron in the pathophysiology of restless legs syndrome. Sleep Med 5:385–391PubMedCrossRefGoogle Scholar
  13. 13.
    Peroutka SJ (1997) Dopamine and migraine. Neurology 49:650–656PubMedGoogle Scholar
  14. 14.
    Akerman S, Goadsby PJ (2007) Dopamine and migraine: biology and clinical implications. Cephalalgia 27:1308–1314PubMedCrossRefGoogle Scholar
  15. 15.
    D’Andrea G, Nordera GP, Perini F et al (2007) Biochemistry of neuromodulation in primary headaches: focus on anomalies of tyrosine metabolism. Neurol Sci 28[Suppl 2]:S94–96PubMedCrossRefGoogle Scholar
  16. 16.
    Denuelle M, Fabre N, Payoux P et al (2007) Hypothalamic activation in spontaneous migraine attacks. Headache 47:1418–1426PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Daniela Cologno
    • 1
  • Giulio Cicarelli
    • 2
  • Vittorio Petretta
    • 2
  • Florindo d’Onofrio
    • 2
  • Gennaro Bussone
    • 3
  1. 1.Clinical Neurophysiology Department of NeuroscienceOspedali “Riuniti”FoggiaItaly
  2. 2.Neurology Unit“S.G. Moscati” HospitalAvellinoItaly
  3. 3.Neurological Institute “C. Besta”MilanItaly

Personalised recommendations