Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD

The long-term effects of monotherapy with levodopa or the dopamine agonist pergolide on the motor/sensory, behavioral, and cognitive variables in seve n children with restless legs syndrome/periodic limb movements in sleep (RL S/PLMS) and attention-deficit-hyperactivity disorder (ADHD) were investigat ed. Five of the seven children had previously been treated with stimulants that had either been determined to be ineffective or to have intolerable si de effects, Dopaminergic therapy improved the symptoms of RLS and reduced t he number of PLMS per hour of sleep (P = 0.018) and associated arousals (P = 0.042) for the entire group. After treatment, three children no longer me t the criteria for ADHD, and three reverted to normal on the Test of Variab le Attention. ADHD improved in all seven as measured by the Connors parent rating scale (P <0.04) and the Child Behavior Checklist (P <0.05). A signif icant improvement also occurred in the visual, but not verbal, memory score s on the Wide Range Assessment of Memory and Learning (P <0.001). Five of s even children continue on dopaminergic therapy 3 Sears after treatment init iation, with good response. We postulate that the improvement in ADHD may b e the result of the amelioration of RLS/PLMS and its associated sleep distu rbance. Alternatively, ADHD and RLS/PLMS may share a common dopaminergic de ficit. (C) 2000 by Elsevier Science Inc, All rights reserved.