Restless Legs Syndrome (RLS) Discussion Board

Do not want to post this one....

A new study suggests that increased RLS/WED severity is associated with subsequent increased risk of stroke. Of course, this is a correlation - that haven't proven causation. But, still. It follows the long line of recent studies showing a correlation between RLS/WED and serious disease. It also could be that these folks have secondary, not primary, WED....but not sure they are looking at that, yet.

http://medicalxpress.com/news/2015-06-l ... drome.html

Interesting! Very preliminary, however...

"An intriguing study shows that deep-brain stimulation (DBS) may be an effective treatment for symptoms of restless leg syndrome (RLS)."

http://www.medscape.com/viewarticle/847146

ViewsAskew wrote:Well, as someone with severe WED/RLS, I'd be annoyed if they said that I couldn't have a severe case because I had no pain and high PLMI!

and regarding the article posted by Steve, The Pain Component of RLS:

The problem is the way they define severity. They measure frequency of sensations but not intensity. These guys are fumbling around; the obvious - to us, anyway - is slipping through the cracks of their floorboards.

Mouse model for PTPRD associations with WED/RLS and addiction: reduced expression alters locomotion, sleep behaviors and cocaine-conditioned place preference.
Drgonova J, Walther D, Wang KJ, Hartstein GL, Lochte B, Troncoso J, Uetani N, Iwakura Y, Uhl GR.

Abstract

The receptor type protein tyrosine phosphatase D (PTPRD) gene encodes a cell adhesion molecule likely to influence development and connections of addiction-, locomotion- and sleep-related brain circuits in which it is expressed. The PTPRD gene harbors genome wide association signals in studies of restless leg syndrome (Willis-Ekbom/RLS; p < 10-8) and addiction- related phenotypes (clusters of nearby SNPs with 10-2 > p > 10-8 associations in several reports). We now report work that seeks a) association between PTPRD genotypes and expression of its mRNA in postmortem human brains and b) RLS-related, addiction-related and comparison behavioral phenotypes in hetero- and homozygous PTPRD knockout mice. We identify associations between PTPRD SNPs and levels of PTPRD mRNA in human brain samples that support validity of mouse models with altered PTPRD expression. Knockouts display less behaviorally-defined sleep at the end of their active periods. Heterozygotes move more despite motor weakness/impersistence. Heterozygotes display shifted dose-response relationships for cocaine reward. They display greater preference for places paired with 5 mg/kg cocaine and less preference for places paired with 10 or 20 mg/kg. The combined data provide support for roles for common, level-of-expression PTPRD variation in locomotor, sleep and drug reward phenotypes relevant to RLS and addiction. Taken together, mouse and human results identify PTPRD as a novel therapeutic target for RLS and addiction phenotypes.

SUMMARY OF RECOMMENDATIONS FOR THE PREVENTION AND TREATMENT OF RLS/WED AUGMENTATION, A COMBINED TASK FORCE OF THE IRLSSG, EURLSSG AND THE RLS ‐ FOUNDATION

This is a White Paper that discusses the latest recommendations for the treatment of both RLS and Augmentation. The recommendations generally recommend that new patients be started out on alpha-2-delta medications unless there are extenuating circumstances, such as depression or past tendencies toward suicide. The recommendations then continue with specific recommendations for the treatment of patients who are experiencing augmentation. These include switching to alpha-2-deltas or to rotigatine for low to intermediate levels of augmentation and reserves opiates for severe conditions.

It should also be noted that there are several places in the white paper where statements made about physicians not familiar with the long term treatment of RLS or who are uncomfortable with prescribing opiates for the treatment of RLS. In the first case, the guidance is to keep medication levels as low as possible. In the second, the paper recommends referring the patient to a physician experienced in managing RLS.

http://irlssg.org/wp-content/uploads/2015/05/Summary-of-recommendations-RLS-Augmentation-13Aug2015.pdf

Excellent information.

One of the more balanced reports I've seen about this:

http://www.eurekalert.org/pub_releases/ ... 100815.php

A few quotes:

"A new database study of Veterans finds, not surprisingly, that those with RLS are at higher risk for stroke, heart and kidney disease, and earlier death. Some studies in the past had suggested such links, but the new research provides the strongest evidence yet."

"Part of the study's strength is its use of "propensity matching." Out of a database of more than 3 million Veterans, the researchers selected about 3,700 with a new RLS diagnosis. Then they selected about 3,700 Veterans without the condition, but who were matched to the first group on more than 20 demographic and clinical factors. The team then tracked the two patient groups for about eight years and compared their outcomes. Specifically, the researchers looked for new cases of stroke, coronary heart disease, chronic kidney disease, or death from any cause."

"Importantly, the study doesn't show that RLS directly brings on any of the other conditions--only that there's an association. In fact, it could be that RLS may result, in part, from other underlying health conditions. There's also a genetic component: The condition, which can occur at any age, often runs in families and specific gene variants have been linked to it."

Interesting....

http://www.renalandurologynews.com/kidn ... le/452433/

While this was about dialysis patients and RLS/WED, this may offer some insight into the rest of us:

"Using the International RLS Study Group rating scale, Rosilene M. Elias, MD, PhD, of the University of Sao Paulo in Brazil, and colleagues identified RLS in 28.7% of 129 HD patients. Patients with greater RLS severity tended to be women and those presenting with low serum calcium, higher serum phosphate, lower iron, and a tendency toward lower transferrin saturation.

"RLS severity scores were significantly related to the dose of erythropoietin, ionized calcium, serum phosphate, and serum albumin. Serum phosphate and vitamin D deficiency were the main factors associated with severity, according to a model adjusted for iron metabolism, hemoglobin, and gender."

I'd love to see how that compares to people without kidney disease and see if any of these show up in folks without CKD. I do believe one study showed vitamin D already, so that may be something we should all be looking at.

Now, THIS could be awesome news....

http://www.inquisitr.com/2552192/canadi ... n-barrier/

Essentially, a doctor just broke the blood brain barrier to successfully treat cancer. The implications are profound.

Very small study and single blind, if I'm reading it correctly. But would be interesting to follow up:

https://www.dovepress.com/serum-endocan ... rticle-NDT

A bit from the study:
"Conclusion: The results of this study seem to suggest that patients with RLS may have better endothelial functions when compared with the general population and that these patients may be better protected against atherosclerosis."

Indeed - it's not often that we see a positive.

Polar Bear wrote:Indeed - it's not often that we see a positive.

Indeed!!!!!

A not so positive:

http://journals.plos.org/plosone/articl ... ne.0140632

"Conclusions"

"RLS patients suffer a greater humanistic and economic burden than those without RLS. Moreover as severity increases so does the burden of RLS."

Truly a fascinating disease we all have .

Using near infrared light to manage symptoms associated with restless legs syndrome. http://www.ncbi.nlm.nih.gov/pubmed/26756803. A quote from the article,"A significant improvement in IRLSRS scores was observed."

Small study - and since I only have the abstract, who knows how it was designed or what symptoms and how severe. But, really fascinating. And, it appears to have replicated similar results from another small study in 2011.

Nice to see a positive quote.