Validation of the Lithuanian Version of the International Restless Legs Syndrome Study Group Rating Scale for...

Background and Objectives: According to the literature, Restless Legs Syndrome (RLS) often remains underdiagnosed, with only a small proportion of individuals experiencing symptoms receiving an official diagnosis, highlighting the need for effective screening and diagnostic tools. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) is a widely used tool for assessing the severity of Restless Legs Syndrome (RLS). However, a validated Lithuanian version has not yet been established. This study aimed to validate the Lithuanian version of the IRLS and assess its reliability, diagnostic performance, and correlation with clinical and demographic factors. Materials and Methods: This retrospective study included 136 patients who completed the Lithuanian version of the IRLS and underwent polysomnographic and clinical evaluations at the Department of Neurology of the Lithuanian University of Health Sciences between 2018 and 2024. A total of 134 patients were analyzed: 66 with clinically confirmed RLS and 68 controls without sleep disorders. Statistical analysis included the Mann-Whitney U test, chi-squared tests, Receiver Operating Characteristics (ROC) curve analysis, multivariate logistic regression, and Akaike Information Criterion (AIC). Results: The Lithuanian IRLS demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) value of 0.843 (95% CI: 0.782-0.904), with an optimal cut-off score of 7.50, resulting in high sensitivity (92.4%) and moderate specificity (66.2%). Multivariate regression identified higher IRLS scores (OR = 1.212, 95% CI: 1.084-1.356, p < 0.001) and a higher periodic limb movements of sleep arousal index (PLMSAI) (OR = 1.961, 95% CI: 1.036-3.712, p = 0.039) as significant independent predictors of RLS. After adjustments for age and sex, both IRLS scores and PLMSAI remained statistically significant predictors. Conclusions: the Lithuanian version of IRLS is a valid and reliable instrument for assessing RLS severity. Its diagnostic performance supports its use in clinical and research settings for identifying and monitoring RLS in Lithuanian population.