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Cabergoline reverses cortical hyperexcitability in patients with restless legs syndrome

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Nardone R, Ausserer H, Bratti A, Covi M, Lochner P, Marth R, Tezzon F. Cabergoline reverses cortical hyperexcitability in patients with restless legs syndrome.

Acta Neurol Scand 2006: 114: 244–249.

© 2006 The Authors Journal compilation 2006 Blackwell Munksgaard. Objective – 

To reverse the profile of abnormal intracortical excitability in patients with restless legs syndrome (RLS) by administering the dopaminergic agonist cabergoline. Methods – 

The effects of this drug on motor cortex excitability were examined with a range of transcranial magnetic stimulation (TMS) protocols before and after administration of cabergoline over a period of 4 weeks in 14 patients with RLS and in 15 healthy volunteers. Measures of cortical excitability included central motor conduction time; resting and active motor threshold to TMS; duration of the cortical silent period; short latency intracortical inhibition (SICI) and intracortical facilitation using a paired-pulse TMS technique. Results – 

Short latency intracortical inhibition was significantly reduced in RLS patients compared with the controls and this abnormal profile was reversed by treatment with cabergoline; the other TMS parameters did not differ significantly from the controls and remained unaffected after treatment with cabergoline. Cabergoline had no effect on cortical excitability of the normal subjects. Conclusions – 

As dopaminergic drugs are known to increase SICI, our findings suggest that RLS may be caused by a central nervous system dopaminergic dysfunction. This study demonstrates that the cortical hyperexcitability of RLS is reversed by cabergoline, and provides physiological evidence that this dopamine agonist may be a potentially efficacious option for the treatment of RLS.

Keywords: cabergoline; dopaminergic agonist; intracortical inhibition; restless legs syndrome; transcranial magnetic stimulation

Document Type: Research Article


Publication date: 2006-10-01

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