Motor Restlessness Research Articles

Disconnect between sensory and motor features of restless legs syndrome during the suggested immobilization test

The Suggested Immobilization Test (SIT) was developed as an objective diagnostic tool to quantify motor restlessness periodic limb movements during wakefulness (PLMW) associated with Restless Legs Syndrome (RLS). Limited research has explored the relationship between discomfort and pain associated with motor activity in RLS during the SIT. Twenty-five RLS patients and ten control participants completed the International Restless Legs Syndrome Study Group Severity Scale and the SIT with bilateral recordings of tibialis anterior EMG (PLMW index), as well as pain and discomfort visual analogue scales every 5 min for the 60-min SIT. The discomfort score had the ability to discriminate between RLS and control participants (P = 0.0001); however, the PLMW index did not (P = 0.67). The RLS patients also exhibited greater discomfort and pain in the latter half of the SIT (P < 0.05) compared to the initial phase of the SIT and compared to controls. Despite rating significant levels of discomfort, the majority of the RLS patients did not exhibit PLMW possibly suggesting a disconnect between the sensory and motor components of RLS. These sensory and motor features may be independent and as such presentation of PLMW during the SIT may not be a reliable objective measure of RLS.

Pathological Laughter as a Symptom of Middle Cerebral Artery Stroke

BackgroundPathological laughter is defined as uncontrollable and inappropriate laughter unrelated to an emotion or a mood. This symptom can reveal a stroke. Case ReportWe described the case of a 57-year-old patient who presented to the emergency department 2 h after a sudden onset of left hemiparesis preceded by pathological laughter. The left motor weakness was very discrete and underestimated because of severe behavioral changes, that is, laughter, joviality, and motor restlessness. Despite abnormal brain imaging results, symptoms were considered as atypical to evoke a stroke. The patient did not receive intravenous thrombolysis. Brain magnetic resonance imaging performed 2 days after admission confirmed the diagnosis of stroke. Why Should an Emergency Physician Be Aware of This?Emergency physicians are at the forefront of stroke management. They should be aware that the initial symptom of a stroke can be atypical and lead to misunderstanding the diagnosis. Because the treatment of stroke requires the fastest care, it is important for emergency physicians to know that sudden behavioral troubles and pathological laughter can reveal strokes.

Restless legs syndrome, leg motor restlessness and their variants in patients with Parkinson's disease and related disorders

ObjectiveThe objective of this study was to investigate the prevalence of restless leg syndrome (RLS), leg motor restlessness (LMR) and RLS/LMR variants and their relationship with clinical factors in patients with Parkinson's disease (PD) and related disorders. MethodsSixty-three PD patients, 17 multiple system atrophy (MSA) patients and 11 progressive supranuclear palsy (PSP) patients were included in this study. Through face-to-face interviews, the patients were diagnosed with RLS/LMR, or with RLS/LMR variants in which the symptoms occur predominantly in body parts other than the legs. ResultsThe frequency of RLS, LMR, RLS variants and LMR variants was as follows: PD (12.7%, 11.1%, 0% and 1.6%); MSA (5.9%, 11.8%, 0% and 0%); and PSP (0%, 9.1%, 0% and 0%). Restlessness without the urge to move was observed in 25.4% of the PD patients, 11.8% of the MSA patients and 0% of the PSP patients. The PD patients with restlessness exhibited higher Hoehn and Yahr stages and higher scores on the Scales for Outcomes in PD-Autonomic, PD sleep scale-2 and Beck Depression Inventory-II. The olfactory functioning, 123I-MIBG myocardial scintigraphy uptake and dopamine transporter single photon emission computed tomography findings did not differ between the PD patients with restlessness and those without. The severity of RLS was correlated with the autonomic symptoms among the PD patients with restlessness. ConclusionPD with restlessness was characterized by increased autonomic, sleep and depressive symptoms. Further studies including a large sample are warranted to characterize restlessness in PD and related disorders.

Uncomfortable and unpleasant sensations in the legs without an urge to move as the initial manifestation of Parkinson’s disease

A 74-year-old man presented with creepy, dull and restless sensation of the legs for a year. The abnormal leg sensation occurred predominantly during rest and evening. However, the patient denied having the urge to move his legs. The abnormal sensations did not fulfill the criteria for restless legs syndrome (RLS) or leg motor restlessness, a condition in which an urge to move the legs exists but not fulfilling 4 essential features of RLS. Neurological examination showed right-side dominant parkinsonism. Dopaminergic treatment provided marked improvement in the leg restlessness and parkinsonism. Any restlessness or abnormal sensation in the legs at late-onset could be an early sensorimotor manifestation of PD.

Prevalence and Clinical Characteristics of the Restless Legs Syndrome (RLS) in Patients Diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) in Antioquia.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral issue for children. One of the sleeping disorders most frequently related to ADHD is the Restless Legs Syndrome (RLS), characterized by an irresistible urge to move the legs, something that is generally associated with paresthesias and motor restlessness. The prevalence rate of RLS in children diagnosed with ADHD is close to 18%, but in Colombia, these cases have been hardly studied. Objective: To determine the frequency of RLS, in children with ADHD. Methods: A cross-sectional study, filled out by parents of children diagnosed with ADHD, were analyzed. This questionnaire contained clinical criteria for classifying ADHD according to the DSM-IV, as well as diagnostic criteria for RLS by the National Institutes of Health (2003). Results: A predominance rate of 65.6% in combined ADHD was observed in children with RLS criteria. Upon carrying out an exploratory data analysis, it was found that having a family history of RLS and belonging to the middle or low socioeconomic strata are conditions associated with the presence of RLS in children with ADHD, with a significant p (p < 0.000) and a PR of 4.47 (3.16-6.32). Conclusions: The prevalence of RLS was similar to the findings of other clinical investigations. However, it highlights new prevalence values in relation to the comorbidity between ADHD and RLS, suggesting the need for new clinical and therapeutic alternatives amidst the presence of both syndromes.

Incidence of antiemetic-induced akathisia in patients at a comprehensive cancer center.

Akathisia is a common and severely disabling medication-induced movement disorder. The condition is often missed, and patients suffer for a long time until diagnosed and managed properly. It is important to bring awareness to the clinicians for early detection and management of akathisia. We reviewed a 4-year record of patients seen at a comprehensive cancer center for anxiety and restlessness. Patients diagnosed with akathisia and the medications causing akathisia were identified. Management of akathisia is discussed. The results showed that 4.7% of patients developed akathisia while taking antiemetic agents to control chemotherapy-induced nausea/vomiting. Early detection and management of akathisia resulted in quick recovery and reduced patients' suffering. Akathisia is an unpleasant feeling of motor restlessness with anxiety. Clinicians need to have a full understanding to identify the subtle difference between functional anxiety and akathisia.

Drug-Induced Akathisia

Akathisia consists of subjective inner restlessness, such as awareness of the inability to remain seated, restless legs, fidgetiness, and the desire to move constantly, and of objective increased motor phenomena, such as body rocking, shifting from foot to foot, stamping in place, crossing and uncrossing legs, pacing around. Although the broad definition of akathisia includes the inner and motor restlessness observed in patients with idiopathic Parkinson's disease, post-encephalitic parkinsonism, and restless legs syndrome, here we exclusively focus on the narrow definition of antipsychotic-induced akathisia. The most reliable treatment for acute akathisia is the reduction or the withdrawal of antipsychotic medication. However, this is often not possible because it may worsen the patients' mental condition. Various pharmacological agents have been used for the treatment of this condition. These include anticholinergic agents (e.g., biperiden and trihexyphenidyl), benzodiazepines, beta-adrenoceptor blockers (e.g., propranolol), and serotonin 2A receptor antagonists (e.g., mianserin, cyproheptadine, and mirtazapine).

Restless legs syndrome and leg motor restlessness in patients with Parkinson's disease: a multicenter case-controlled study

Restless legs syndrome and leg motor restlessness in patients with Parkinson's disease: a multicenter case-controlled study

Restless legs syndrome, leg motor restlessness and their variants in patients with Parkinson’s disease and related disorders

Restless legs syndrome, leg motor restlessness and their variants in patients with Parkinson’s disease and related disorders

Protocol for the management of psychiatric patients with psychomotor agitation

BackgroundPsychomotor agitation (PMA) is a state of motor restlessness and mental tension that requires prompt recognition, appropriate assessment and management to minimize anxiety for the patient and reduce the risk for escalation to aggression and violence. Standardized and applicable protocols and algorithms can assist healthcare providers to identify patients at risk of PMA, achieve timely diagnosis and implement minimally invasive management strategies to ensure patient and staff safety and resolution of the episode.MethodsSpanish experts in PMA from different disciplines (psychiatrists, psychologists and nurses) convened in Barcelona for a meeting in April 2016. Based on recently issued international consensus guidelines on the standard of care for psychiatric patients with PMA, the meeting provided the opportunity to address the complexities in the assessment and management of PMA from different perspectives. The attendees worked towards producing a consensus for a unified approach to PMA according to the local standards of care and current local legislations. The draft protocol developed was reviewed and ratified by all members of the panel prior to its presentation to the Catalan Society of Psychiatry and Mental Health, the Spanish Society of Biological Psychiatry (SEPB) and the Spanish Network Centre for Research in Mental Health (CIBERSAM) for input. The final protocol and algorithms were then submitted to these organizations for endorsement.ResultsThe protocol presented here provides guidance on the appropriate selection and use of pharmacological agents (inhaled/oral/IM), seclusion, and physical restraint for psychiatric patients suspected of or presenting with PMA. The protocol is applicable within the Spanish healthcare system. Implementation of the protocol and the constituent algorithms described here should ensure the best standard of care of patients at risk of PMA. Episodes of PMA could be identified earlier in their clinical course and patients could be managed in the least invasive and coercive manner, ensuring their own safety and that of others around them.ConclusionEstablishing specialized teams in agitation and providing them with continued training on the identification of agitation, patient management and therapeutic alternatives might reduce the burden of PMA for both the patient and the healthcare system.

Characterizing restless legs syndrome and leg motor restlessness in patients with Parkinson's disease: A multicenter case-controlled study

BackgroundWe investigated the prevalence and impact of restless legs syndrome (RLS) and leg motor restlessness (LMR) in patients with Parkinson's disease (PD) in a multicenter study. MethodsA total of 436 PD patients and 401 age- and sex-matched controls were included in this study. RLS was diagnosed based on four essential features. LMR was diagnosed when a participant exhibited the urge to move his or her legs but did not meet the four essential features of RLS. ResultsThe RLS prevalence did not differ between PD patients and controls (3.4% vs. 2.7%), while LMR prevalence was significantly higher in PD patients than in controls (12.8% vs. 4.5%). PD patients with RLS or LMR had a higher prevalence of excessive daytime sleepiness (EDS) (50.7%, vs. 6.9%), probable REM sleep behavior disorder (38.0% vs. 3.4%) and PD-related sleep problems (49.3% vs. 20.7%) than controls with RLS or LMR. RLS/LMR preceding PD onset was related to an older age of PD onset. ConclusionOur study revealed an increased prevalence of LMR but not RLS in PD patients. LMR could be an early manifestation of PD; however, whether LMR is within the range of RLS or whether LMR and RLS constitute different entities in PD requires further studies.

Impact of nonideaton states on youth suicide attempts

BackgroundYouth nonideation suicidality (NIS), distinct from impulsive deliberate-self harm (DSH), is a potential consequence of adjustment disorder (AD) or selective serotonin reuptake inhibitor (SSRI) adverse reaction. It is characterized by the absence of transient or enduring ideation. A new measure was constructed to evaluate the impact of NIS on attempt rates.MethodsYouth 8 to 24-years-old were recruited in this case control study. Entry criteria included DSH (n = 50), AD (n = 91), and SSRI (n = 29) emergent events with overt or suspected NIS, worsening of existing or new onset suicidality, or abrupt mental status or behavioral change. Exclusion criteria included sensorimotor deficit or primary depressive disorder. Ratings from the new measure utilized dichotomous as well as outcome scores, and compared to ratings from other validated scales, after controlling for depression and other matched factors.ResultsHigh risk AD and SSRI groups presented with abrupt onset, high lethality attempt, intense motor restlessness, great intra-psychic distress, and irresistable suicidality. AD symptoms overlapped with SSRI presentations. Eighty-one percent of the AD sample reported no ideation; however, 96% made an attempt. For the SSRI group, 52% reported no ideation; however, 95% made an attempt. Sensitivity 80.3%, specificity 98.1%. Internal consistency 0.75 to 0.92. Test-retest scores 0.78 to 0.98, and neurodiagnostic correlations 0.70 to 0.98. Some scores correlated significantly with the “gold standard” Barnes Akathisia Rating Scale.ConclusionNIS is associated with alarmingly high rates of youth suicide attempt. The new neuropsychological measure demonstrates practical screening value in unobvious NIS proposed to represent a heretofore unrecognized neural mechanism.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Early Onset Parkinson's disease due to DJ1 mutations: An Indian study

IntroductionEarly Onset Parkinson's Disease (EOPD) is genetically heterogeneous. PARK2 mutations are the commonest cause of autosomal recessive EOPD followed by PINK1.DJ1 mutations is rare and there is scarce literature on its phenotype and long term outcome. ObjectivesWe undertook a retrospective study to determine the prevalence of DJ1 mutation(s) in an Indian population and describe the clinical features and long term outcome of EOPD patients with these mutations. MethodsOne hundred EOPD patients and 114 controls were evaluated. All the seven coding exons of DJ1 gene were screened for novel and reported mutations by PCR- Sanger sequencing. ResultsA novel homozygous missense mutation (c.313 A > T, p. Ile105Phe) in exon 5 was seen in one patient and four unrelated patients had a homozygous missense single nucleotide variant rs71653619 (c.293 G > A, p.Arg98Gln). The clinical phenotype comprised of asymmetrical onset, slowly progressive Parkinsonism with levodopa induced motor restlessness in a patient with the novel mutation (c.313 A > T, p. Ile105Phe) while subjects with c.293 G > A, p.Arg98Gln had early onset levodopa responsive symmetrical Parkinsonism. ConclusionDJ1 mutations account for ∼5% of EOPD patients from the Indian population. This study further adds to the clinical spectrum of EOPD with DJ1 mutations.

Female With Severe Shock

A 51-year-old woman presented to the emergency department (ED) with severe shock, unresponsiveness, and motor restlessness. She had been found unconscious in an open field with horses. Primary survey revealed a self-maintained airway and spontaneous breathing without external blood loss. Glasgow Coma Scale score was 7. Complete physical examination revealed parasternal bruising resembling a horseshoe print (Figure 1). Initial systolic blood pressure was between 70 and 90 mm Hg, with a pulse rate of 130 beats/min, with no improvement despite volume replacement with 0.9% normal saline solution. After intubation, a markedly elevated jugular venous pressure was observed and sinus tachycardia persisted. A pulsus paradoxus was not observed. Chest radiograph showed an enlarged cardiac silhouette (Figure 2). Abdominal ultrasonography result was normal. Bedside cardiac ultrasonography was not available in the ED.Figure 2Chest radiograph showing enlarged cardiac silhouette.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Cardiac tamponade caused by a blunt thoracic trauma. Initial diagnosis of traumatic cardiac tamponade is difficult, especially in blunt chest injury. Clinical suspicion increases when sinus tachycardia, elevated jugular venous pressure, or pulsus paradoxus is present and irresponsive to volume replacement.1Spodick D.H. Acute cardiac tamponade.N Engl J Med. 2003; 349: 684-690Crossref PubMed Scopus (530) Google Scholar Blood in the pericardial sac causes pressure on the cardiac ventricles and reduces diastolic compliance, and then causes a decrease in systemic and venous return, and eventually death from cardiogenic shock, ie, cardiac tamponade.1Spodick D.H. Acute cardiac tamponade.N Engl J Med. 2003; 349: 684-690Crossref PubMed Scopus (530) Google Scholar, 2Von Wachenfelt H, Nilsson C, Ventorp M. Measurement of kick loads from horses on stable fittings and building elements. 2013. Available at: http://pub.epsilon.slu.se/10949/7/wachenfelt_etal_131220.pdf. Accessed April 2, 2015.Google Scholar, 3Fitzgerald M. Spencer J. Johnson F. et al.Definitive management of acute cardiac tamponade secondary to blunt trauma.Emerg Med Australas. 2005; 17: 494-499Crossref PubMed Scopus (47) Google Scholar Our patient immediately underwent needle pericardiocentesis at the ED (Figure 3), where 150 mL of blood was drained, resulting in hemodynamic stability. After the pericardiocentesis, right-sided cardiac failure developed, which was successfully treated with diuretics. The patient fully recovered and was discharged home after 9 days.

Paradoxical Reaction to Alprazolam in an Elderly Woman with a History of Anxiety, Mood Disorders, and Hypothyroidism.

With less than 1% of patients who use benzodiazepines being affected, paradoxical responses to benzodiazepines are rare. In this case report, we outline the course of an 80-year-old female who developed a paradoxical response to benzodiazepines. Significant medical and psychiatric history includes anxiety, mood disorder, hypothyroidism, bilateral mastectomy, goiter removal, and triple bypass. The patient presented with mental status changes, anxiety, motor restlessness, and paranoia. Over time, a temporal relationship between the severity of the patient's motor agitation and intake of alprazolam was observed. As doses of alprazolam were decreased, her motor agitation became less severe. In addition to motor agitation, the patient also demonstrated increased aggressiveness, a subjective feeling of restlessness, and increased talkativeness. As her dose of alprazolam decreased, many of the patient's symptoms were observed to decrease. This case report also discusses theories regarding the pathophysiology of paradoxical reactions to benzodiazepines, known risk factors, and appropriate treatment.

Amlodipine and the Successful Management of Post-Electroconvulsive Therapy Agitation.

Electroconvulsive therapy (ECT) is a highly effective nonpharmacologic treatment for the management of depression and some other psychiatric disorders. Post-ECT agitation occurs in up to 12% of ECT treatments and is characterized by motor restlessness, irritability, disorientation, and panic-like behaviors. The severity of post-ECT agitation ranges from mild and self-limited to serious and severe forms requiring prompt medical intervention to protect the patient and the medical staff. In severe agitation medical management may be necessary which consists of using sedative agents, either benzodiazepines or propofol. The side-effects of these sedative agents, especially in the elderly population, necessitate finding ways that could help the prevention of the occurrence of agitation after ECT treatments. We report a 68-year-old female with major depression who was referred for ECT. She experienced severe post-ECT agitation requiring medical intervention after all ECT treatments. Administering of oral amlodipine (5 mg) one hour before ECT treatment successfully prevented the occurrence of post-ECT agitation in this patient. We briefly discuss the possible underlying mechanisms and pathophysiology of amlodipine in the prevention of post-ECT agitation.

Pathological laughter as prodromal manifestation of transient ischemic attacks—case report and brief review

BackgroundBased on a case report, the authors reviewed the data about involuntary emotional expression disorder (IEED). IEED includes the syndromes of pathological laughing and crying (PLC) and emotional lability (EL). PLC is a rare disorder of emotional expression characterized by relatively uncontrollable episodes of laughter and crying or both that do not have an apparent motivating stimulus.Case presentationAuthors report the case of a 59-year-old man who presented with recurrent episodes of PLC of approximately 2 min duration, consisting of accelerated breathing, emission of guttural, snoring sounds, frowning of the eyebrows, followed by laughter accompanied by motor restlessness of all four limbs. PLC episodes preceded left carotid transient ischemic attacks (TIA’s) manifested by reversible aphasia and right hemiparesis. Electroencephalography performed during PLC episodes revealed no spike-wave activity. Brain magnetic resonance imaging showed lacunar infarcts in the left lenticulo-capsulo-thalamic area and multiple round lesions in the cortical-subcortical and in the deep white matter of frontal-parietal-occipital lobes bilaterally, with T2 hyperintensity, T1 isointensity and no diffusion changes. The episodes were interpreted as transient ischemic attacks although gelastic seizures could not be excluded. The etiological investigations revealed unstable plaques on the left carotid artery bulb and the aortic arch and a degenerative mitral valve stenosis. The patient was treated first with antiplatelet therapy and antiepileptic drugs but PLC stopped only after anticoagulation was started. During follow-up the patient continued to have left carotid and vertebrobasilar TIA’s being on oral anticoagulation. The patient became asymptomatic only after mitral valve replacement was performed.ConclusionsThis case illustrates the difficulty distinguishing between gelastic epilepsy and TIA’s in cases of PLC episodes and discuss the neuroanatomic bases and pathophysiology of this rare condition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0457-3) contains supplementary material, which is available to authorized users.

Clinical characteristics of leg restlessness in Parkinson's disease compared with idiopathic Restless Legs Syndrome

ObjectiveThere is limited data on motor restlessness in Parkinson's disease (PD). Here we evaluate for clinical differences between cohorts of idiopathic Restless Legs Syndrome (iRLS), PD patients with leg restlessness, and PD with RLS. MethodsWe examined 276 consecutive PD patients for leg restlessness symptoms, we compared clinical features of PD patients with RLS, PD patients with leg restlessness but not meeting RLS criteria, PD patient without RLS and iRLS. ResultsA total of 262 PD patients who satisfied the inclusion criteria were analyzed. After excluding 23 possible secondary RLS or mimics, 28 were diagnosed with RLS and 18 with leg motor restlessness (LMR). Compared with iRLS patients, PD patients with RLS or LMR had older age of RLS/LMR onset, shorter duration of leg restlessness, less positive family history, different seasonal trends and more unilaterality of leg restlessness symptom (P<0.01) which were often in accordance with dominant Parkinsonism side and related with Parkinsonism severity. PD patients with RLS/LMR had lower daily dosage (P<0.01) and shorter duration (P<0.05) of dopaminergic medication when RLS/LMR symptom onset than PD without leg restlessness. PD with LMR had less severe Parkinsonism (P<0.05) and leg restlessness (P<0.01) symptoms than PD with RLS. ConclusionClinical characteristics of PD patients with RLS and LMR were different from iRLS, differentiating these various subtypes can facilitate optimal treatment.

Status dissociatus and disturbed dreaming in a patient with Morvan syndrome plus myasthenia gravis

A 52-year-old patient suffered from myasthenia gravis with antibodies against acetylcholine receptors and a thymoma, and was successfully treated with surgery, radiotherapy, and azathioprine. At age 60, he experienced non-painful cramps and myokymia in the calves, which progressively spread to the whole body, associated with profuse sweating, non-restorative sleep, and dream-enacting behaviors. Because of dysphagia and dysarthria, he was admitted to the intensive care unit. As there were continuous resting activities with fasciculations andmyokymia but no myasthenia decrement in the electromyography, no malignant thymoma, and no paraneoplastic antibodies, Morvan syndromewas suspected and later confirmed by positive antibodies against contactin-associated protein-like 2. His wife reported that he displayed continuous motor restlessness during the night for the past year. The patient slept on average for 7 h at night and had two 30-min-long naps per day. He always felt “mid-water, neither awake nor asleep,” being conscious throughout the night and yet experiencing an intense and continuous dreaming activity, including epic dreaming (eg, fantastic, prolonged rides in a hot air balloon with gypsies), vivid dreaming (eg, he repeatedly dreamt that his son was cheating on his wife; the dreams seemed so real that he felt obliged to inquire from his son), lucid dreaming (he knew sometimes that he was dreaming), and recurrent contextual dreams. As he was scheduled for a brain scan, he vividly dreamt that the nurses entered his hospital room to bring him to the scanner. As he stood up and put his slippers, he realized that it was 3 am, resumed sleep, and dreamt again, but this time the nurses were coming into the room to warn him that the scanner has been rescheduled another day, and so on. During daytime, he felt sleepy needing four to five naps of 30 min each per day, during which dreaming was less vivid than during nighttime. During nighttime videopolysomnography, the electroencephalographic (EEG) activity contained a continuous, diffuse 9-Hz alpha rhythm (as duringwakefulnesswith eye closed) all night long, without any conventional sleep features (theta activity, spindles, * Corresponding author. Service des Pathologies du Sommeil, Hopital PitieSalpetriere, 47-83 Boulevard de l’Hopital, 75651 Paris Cedex 13, France. Tel.: +33 142 16 77 02; fax: +33 142 16 77 00. E-mail address: isabelle.arnulf@psl.aphp.fr (I. Arnulf).

Further evidence for the association of the NPSR1 gene A/T polymorphism (Asn107Ile) with impulsivity and hyperactivity.

Administration of neuropeptide S (NPS) elicits anxiolysis, arousal and higher activity in rodents. In humans, the NPS receptor (NPSR1) gene rs324981 A/T (Asn(107)Ile) polymorphism is associated with fear responses and anxiety. We have recently revealed an association of NPSR1 with impulsivity-related traits and psychopathology. In the present study the association of the NPSR1 genotype with impulsivity and attention-deficit/hyperactivity disorder (ADHD)-related symptoms was re-examined in two independent non-clinical cohorts. We used self-reports of two population-derived samples of the Estonian Psychobiological Study of Traffic Behaviour (EPSTB): a community car driving sample (n=491, MAge=37) and a driving school student sample (n=773, MAge=24). Impulsivity was measured with the Adaptive and Maladaptive Impulsivity Scale (AMIS) in both samples, and with the Barratt Impulsivity Scale (BIS) in driving schools only. For the latter sample, also measurement of ADHD symptoms was carried out with the Adult ADHD Self-Report Scale (ASRS). NPSR1 T-allele carriers had higher scores of impulsivity, motor restlessness and total ADHD scores. The effect on impulsivity originated from male participants but for ADHD symptoms the association was independent of sex. Thus we have confirmed in two additional population-derived samples that the T-allele of the NPSR1 rs324981 polymorphism is associated with increased impulsivity and ADHD-related traits.