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Restless Leg Syndrome

Discussion in 'General Issues and Discussion Forum' started by Cameron, May 19, 2005.

  1. NewsBot

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    Articles:
    1
    Haste makes waste: Decision making in patients with restless legs syndrome with and without augmentation
    Beatrice Heim, Marie-Theres Pertl, Ambra Stefani, Margarete Delazer, Anna Heidbreder, Laura Zamarian, Elisabeth Brandauer, Klaus Seppi, Birgit Högl, Werner Poewe, Atbin Djamshidian
    PLoS ONE 12(4): e0174793. April 5, 2017
     
  2. NewsBot

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    Articles:
    1
    Placebo and nocebo responses in restless legs syndrome
    A systematic review and meta-analysis

    Maria A. Silva, MD, Gonçalo S. Duarte, MD, Raquel Camara, MD, Filipe B. Rodrigues, MD, Ricardo M. Fernandes, MD, PhD, Daisy Abreu, Tiago Mestre, MD, João Costa, MD, PhD, Claudia Trenkwalder, MD, PhD and Joaquim J. Ferreira, MD, PhD
    Neurology 10.1212/WNL.0000000000004004
     
  3. NewsBot

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    Press Release:
    Study links restless legs syndrome to poor sleep quality, impaired daytime function in pregnant women
    July 14, 2017

    DARIEN, IL – A new study of pregnant women shows that restless legs syndrome (RLS) is common and is strongly associated with poor sleep quality, excessive daytime sleepiness, and poor daytime function, which are frequent complaints during pregnancy.

    Results show that 36 percent of women in their third trimester had RLS, and half of the women with RLS had moderate to severe symptoms. Compared with pregnant women without RLS, those with RLS were twice as likely to report poor sleep quality and poor daytime function, and they were also more likely to have excessive daytime sleepiness. Additionally, the study found a positive dose-response relationship between RLS severity and the sleep-wake disturbances.

    “While we expected that RLS would be relatively common in pregnant women, we were surprised to observe just how many had a severe form,” said lead author Galit Levi Dunietz, PhD, a T32 post-doctoral research fellow at the University of Michigan Sleep Disorders Center in Ann Arbor. “These women experienced RLS symptoms at least four times per week.”

    Study results are published in the July 15 issue of the Journal of Clinical Sleep Medicine.

    The study involved 1,563 pregnant women with an average age of 30 years, each of whom was in her third trimester. RLS was diagnosed using the standardized criteria of self-reported symptoms and frequency. Demographic and pregnancy data were extracted from medical records, and sleep information was collected with questionnaires. The study found no evidence for any association between RLS and delivery outcomes.

    According to the authors, health care providers often dismiss patient complaints of poor sleep and daytime sleepiness during pregnancy.

    “These sleep-wake disturbances are considered common symptoms in pregnancy and are frequently attributed to physiological changes that occur in normal pregnancy, but our data suggest that RLS is an additional contributor to these symptoms,” said Dunietz.

    The authors suggest that the identification and treatment of RLS in pregnancy – using non-pharmacological approaches – may alleviate the burden of these symptoms for many women.

    This study was partially supported by a T32 Grant from the National Institute of Neurological
    Disorders and Stroke (NIH/NINDS T32 NS007222) and by the Gene and Tubie Gilmore Fund for Sleep Research, the University of Michigan Institute for Clinical and Health Research (MICHR) grant UL1TR000433, MICHR seed pilot grant F021024, and the National Heart, Lung, and Blood Institute (R21 HL089918).

    The monthly, peer-reviewed Journal of Clinical Sleep Medicine is the official publication of the American Academy of Sleep Medicine, a professional membership society that improves sleep health and promotes high quality, patient-centered care through advocacy, education, strategic research, and practice standards. The AASM encourages patients to talk to their doctor about sleep problems and visit http://sleepeducation.org/ for more information about sleep, including a searchable directory of AASM-accredited sleep centers.
     
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    Articles:
    1
    Plantar reflex excitability is increased in the evening in restless legs syndrome patients
    Chloe Dafkin et al
    Neuroscience Letters; 14 September 2017
     
  5. drhunt1

    drhunt1 Well-Known Member

  6. NewsBot

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    Articles:
    1
    The Association Between Vitamin D Level and Restless Legs Syndrome: A Population-Based Case-Control Study.
    Wali S, Alsafadi S, Abaalkhail B, Ramadan I, Abulhamail B, Kousa M, Alshamrani R, Faruqui H, Faruqui A, Alama M, Hamed M.
    J Clin Sleep Med. 2018 Mar 30. pii: jc-17-00496
     
  7. NewsBot

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    Articles:
    1
    Plantar reflex excitability is increased in the evening in restless legs syndrome patients.
    Dafkin C et al
    Neurosci Lett. 2017 Nov 1;660:74-78.
     
  8. NewsBot

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    Articles:
    1
    French Consensus: How to diagnose restless legs syndrome
    L.Leclair-VisionneauaM.-F.VecchierinibC.SchrödercdC.Charley Monacae
    Revue Neurologique; 23 July 2018
     
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    PUBLIC RELEASE: 29-AUG-2018
    Restless legs syndrome brain stimulation study supports motor cortex 'excitability' as a cause
    Experiments with patients suggest brain stimulation may be a viable treatment


    Johns Hopkins Medicine researchers say new experiments using magnetic pulse brain stimulation on people with moderate to severe restless legs syndrome (RLS) have added to evidence that the condition is due to excitability and hyperarousal in the part of the brain's motor cortex responsible for leg movement.

    The researchers say their findings, published online in Sleep Medicine on May 31, may help devise safer, more effective ways to treat RLS and the chronic sleep deprivation it causes, using electrical or magnetic pulses to calm or interrupt the hyperarousal. Some 10 percent of adults in the U.S. experience RLS at one time or another, and about 1 in 500 report that the condition is severe and chronic enough to interfere with their quality of life, work productivity or mental health, according to the National Sleep Foundation.

    People with severe RLS describe symptoms of the condition as an overwhelming urge to move their legs when they are at rest. They may feel pain, or the sensation of soda bubbles in their veins or worms crawling in their legs, with relief coming only when standing or deliberately moving their legs. Long-term effects include fatigue, anxiety and depression, much of it linked to repeated interruption of sound sleep. Standard treatments, which may carry significant side effects, include medications that behave like the neurotransmitter dopamine, opioids and anti-seizure drugs.

    Although many conditions, such as kidney disease and diabetes, have been associated with RLS, the neurological roots of the condition have been subject to much debate.

    The new study, the Johns Hopkins researchers say, supports the idea that the underlying mechanism for RLS rests in the brain's "move my legs" center and makes even more sense of the relief those with RLS experience when they get up and move them.

    "Essentially the brain sends the signal when it's preparing to move a limb, even when you aren't planning to move, so your body is ready and amped up," says Richard Allen, Ph.D., professor of neurology at the Johns Hopkins University School of Medicine. "The only way to alleviate the feeling is to move."

    In the new study, the researchers identified 32 adults with a moderate to severe RLS diagnosis from patients and asked them to stop their treatments for 12 days. They recruited 31 adult matched controls with no history of RLS or other sleep disorders and healthy sleeping patterns as controls. Participants in both groups were an average age of 58, and 59 percent were women.

    For the experiments, the researchers used transcranial magnetic stimulation (TMS) to apply safe pulses able to selectively stimulate various regions of the brain that control movement of the muscles in the hand or the leg. They then used electrodes attached to the hand or leg to measure muscle responses in that hand or leg during such stimulations in those with RLS and in the control group.

    Pairing two pulses as a stimulus can either cause a reaction or suppress/inhibit a reaction in a muscle depending on the timing between the two pulses. The researchers looked at one type of excitatory paired pulses and two types of inhibitory pulses¾short- and long-interval ones.

    For each analysis, the researchers took the ratio of the responses. The ratios were greater in the leg for those with RLS, at 0.36 compared with 0.07 for those people without RLS, when looking at the inhibitory long-interval pulses, but not with the short-interval pulses. They said they didn't see a difference in excitatory pulses in the legs.

    "This basically means that inhibition is reduced or weakened in people with restless legs syndrome compared to people without the condition," says Rachel Salas, M.D., associate professor of neurology at Johns Hopkins. "The reduced response means that the region of the brain controlling the legs shows increased cortical excitability in the motor cortex."

    In a separate set of experiments measuring the effect of paired pulses given to the brain in the region that controls the hand, they found no real differences in the ratios of either of the inhibitory pulses¾short- or long-interval ones¾between people with RLS and those without the condition.

    But the researchers say they did find that the ratios picked up from the hand muscles using excitatory pulses were lower, at 1.01 compared with controls with a ratio of 1.85.

    "The measurements from the hand muscles show that the activity in the brain is reduced in the region that controls the hand in people with restless legs syndrome compared to controls," says Salas.

    Salas says that previous research shows that inhibitory pulses are associated with the action of the neurotransmitter GABA, a brain chemical typically known for tamping down activity in the brain's neurons. The researchers say that since there is hyperactivity in the leg-controlling portion of the brain, it's possible that cells and tissues there are lacking enough GABA to prevent hyperactivity.

    "Other studies with TMS have been done on people with RLS, but they didn't look at people with severe forms of the condition or at the long-interval paired pulses in the leg," says Salas. "We are fortunate to have access to such individuals because the Johns Hopkins Sleep Center attracts people worldwide and many who have exhausted treatment options available elsewhere," she adds.

    Salas notes that medications that act like the neurotransmitter dopamine, such as ropinirole or pramipexole, work in the short term but can exacerbate the condition over time. Opioids are effective, but not ideal due to their risk for dependency. With the results of this new study, the researchers are hoping to use electrical stimulation to suppress the brain's activity, and planning of these studies is in the works.
     
  10. NewsBot

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    Press Release:
    Breakthrough in treatment of Restless Legs Syndrome
    15 November 2018

    New research published in The Journal of Physiology presents a breakthrough in the treatment of Restless Legs Syndrome (RLS).

    RLS is a common condition of the nervous system that causes an overwhelming irresistible urge to move the legs. Patients complain of unpleasant symptoms such as tingling, burning and painful cramping sensations in the leg. More than 80% of people with RLS experience their legs jerking or twitching uncontrollably, usually at night.

    Until now it was thought that RLS is caused by genetic, metabolic and central nervous system mechanisms. For the first time the researchers show that, in fact, it is not only the central nervous system but also the nerve cells targeting the muscles themselves that are responsible.

    This new research indicates that the involuntary leg movements in RLS are caused by increased excitability of the nerve cells that supply the muscles in the leg, which results in an increased number of signals being sent between nerve cells. Targeting the way messages are sent between nerve cells to reduce the number of messages to normal levels may help prevent the symptoms of RLS occurring. This could be achieved by new drugs that block the ion channels that are essential for the communication between nerve cells.

    The research conducted by the University of Gottingen in conjunction with the University of Sydney and Vanderbilt University involved measuring the nerve excitability of motor nerve cells of patients suffering with RLS and healthy subjects.

    The next step is to investigate the effect of different medications in patients and the effect on RLS.

    Dirk Czesnik, corresponding author of the study, commented on the findings:

    ‘Patients who suffer from Restless legs syndrome complain of painful symptoms in the legs leading to sleep disturbances. The mechanisms for RLS are still not completely understood. We have shown that also the nerve cells supplying muscles in the leg are responsible and hereby additional drug treatments may be ahead targeting these nerve cells.’
     
  11. drhunt1

    drhunt1 Well-Known Member

    The last paragraph is the best..."The mechanisms for RLS are still not completely understood." Yep...but all they would need to do is read my article, to ascertain that. While there "may be" other causes of RLS, the preponderance is referred pain from the STJ, which is maximally pronated.
     
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    Impaired endothelial function may predict treatment response in restless legs syndrome
    Min Seung KimDong Gyu ParkJung Han Yoon
    Journal of Neural Transmission: 19 June 2019
     
  14. Jeff Carnett

    Jeff Carnett Member

    Yes
    . Acupuncture works well esp if done in traditional methods. Pods cant use it in Australia but elsewhere perhaps.
     
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    Randomized pilot trial for the efficacy of the MMF07 foot massager and heat therapy for restless legs syndrome.
    Park A et al
    PLoS One. 2020 Apr 2;15(4):e0230951
     
  16. NewsBot

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    Press release:
    Novel Treatment Method

    An East Carolina University faculty member’s latest patent may change the way Restless Legs Syndrome (RLS) is treated, leading to more effective care over a longer period of time for patients.

    Stefan Clemens, an associate professor in the Brody School of Medicine’s Department of Physiology, was awarded U.S. Patent 10,751,327 on Aug. 25 for his novel treatment method for the treatment of RLS.

    Restless Legs Syndrome is a nervous system disorder that affects between 5% and 8% of the population in the United States. Those suffering from RLS experience an uncontrollable urge to move their legs caused by an unpleasant sensation. While the exact cause of RLS is still unknown, the syndrome is typically treated with dopaminergic drugs — medications that replace or prevent the loss of dopamine — that have a high initial effect but over time lose their effectiveness.

    “The problem is that patients on these dopaminergics eventually develop a side effect called augmentation,” Clemens said. “Their symptoms get worse while taking the current medication used for treatment.”

    Classic RLS treatments act on a dopamine receptor known as D3 that has a suppressive effect in the nervous system. However, Clemens’ lab has shown in animal models that over time this medication leads to an increase of a different, excitatory receptor subtype, D1. This increase of the D1 receptor might be the cause of augmentation.

    Clemens’ patent proposes a new treatment method that targets the increased D1 receptor levels in RLS patients suffering from augmentation, leading to reduced activation of D1 receptors while providing traditional therapy relief from RLS.

    “Our lab postulates that this new compound will maintain long-term efficacy for RLS,” Clemens said. “If augmentation begins, we predict that we can reduce D1 receptor activation in patients and balance things back out, keeping the treatment effective.”

    Clemens was awarded a grant from the North Carolina Biotechnology Center to run a small pilot study with a collaborator from the University of Houston using this new treatment method.

    This work has gained the attention of a company that has interest in establishing a partnership where ECU’s patent rights may be used in combination with its existing drug formulation to bring relief to RLS patients suffering from augmentation.

    Clemens added that the idea to apply for a patent came from ECU’s Office of Licensing and Commercialization.

    “They not only brought the idea of patenting our research to my attention, but they also helped me through the process and handled all of the legal and technical aspects of filing a patent,” he said. “The patent would not have been issued without their help. I now know that it can be very beneficial to have experts in other areas come from different angles that make us think of other ways to use our work.”

    Marti Van Scott, director of licensing and commercialization, said that finding commercialization opportunities for faculty research is an important bridge that brings science into the communities the university serves.

    “It is a pleasure to work alongside our faculty to identify translational research opportunities that have potential to make a meaningful impact,” Van Scott said. “Licensing and commercialization works hard to identify skilled development partners to offer essential guidance for these translational activities. Whether it’s a new therapeutic or medical device, teaching or training method, or research tool, we are available to support the campus research and innovation ecosystem.”

    While Clemens’ lab continues to work on its RLS treatment, Clemens said he’s also continuing to work on other medical treatments, including care for opioid pain tolerance.
     
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    Articles:
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    Contrasting Painful and Painless Restless Legs Phenotypes: An Adult Twin Family Study
    David Champion, Minh Bui, Phillip Aouad, Georgia Ng, Emily Joyce, Arthur Teng, Elias Karroum, Arthur Walters, Tiina Jaaniste, John Hopper
    Sleep, Volume 46, Issue Supplement_1, May 2023, Page A307, https://doi.org/10.1093/sleep/zsad077.0698
     
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