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. 2021 Mar 17;11(3):383.
doi: 10.3390/brainsci11030383.

Birds of a Feather Flock Together: Disadvantageous Decision Making in Augmented Restless Legs Syndrome Patients with and without Impulse Control Disorders

Beatrice Heim  1 , Philipp Ellmerer  1 , Ambra Stefani  1 , Anna Heidbreder  1 , Elisabeth Brandauer  1 , Birgit Högl  1 , Klaus Seppi  1 , Atbin Djamshidian  1
Affiliations

Birds of a Feather Flock Together: Disadvantageous Decision Making in Augmented Restless Legs Syndrome Patients with and without Impulse Control Disorders

Beatrice Heim et al. Brain Sci. .

Abstract

Background: Augmentation (AUG) in patients with restless legs syndrome (RLS) can be associated with impulse control disorder (ICD) symptoms, such as compulsive sexual behavior, gambling disorder or compulsive shopping. In this study, we wanted to assess whether RLS patients with AUG differ in decision making from those patients who have augmentation and in addition ICD symptoms (AUG + ICD) in a post hoc analysis of a patient cohort assessed in a previous study.

Methods: In total, 40 RLS patients with augmentation (19 AUG + ICD, 21 AUG without ICDs) were included. RLS diagnosis, severity, and diagnosis of augmentation were made by sleep disorder specialists. ICD symptoms were assessed using semi-structured interviews. All patients performed the beads task, which is an information sampling task where participants must decide from which of the two cups colored beads were drawn. Results were compared to 21 healthy controls (HC).

Results: There was no difference in information sampling or irrational decision making between AUG and AUG + ICD patients (p = 0.67 and p = 1.00, respectively). Both patient groups drew less beads and made more irrational decisions than HC (all p-values < 0.03, respectively).

Conclusions: Our results suggest that augmentation itself is associated with poorer decision making even in the absence of ICD symptoms. Further studies are necessary to explore whether rapid and hasty decision making are a harbinger of augmentation in RLS.

Keywords: behavioral abnormalities; decision making; impulsivity; restless legs syndrome.

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Conflict of interest statement

The authors report no sources of funding and no conflict of interest. The authors declare that there are no disclosures to report.

Figures

Figure 1
Figure 1
(A) average beads drawn per group; (B) average irrational decisions made per group. Error bars are +/− SE, 95% Cl. Significant differences are labelled with “*”; * p < 0.05; *** p < 0.001. AUG, RLS patients with augmentation only; AUG + ICD, augmented RLS patients with ICD symptoms; HC, healthy controls.
See this image and copyright information in PMC

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