Published Research - General Sleep and RLS (WED)

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ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

Steve - I also appreciated the focus on how cause and effect are completely unknown. As with many things, systems are complex and what is often thought to be a clear cause is not that at all!

Additionally, I appreciate that it's open access.
Ann - Take what you need, leave the rest

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badnights
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Epidural implant helps WED/RLS in a person with neuropathic pain

Post by badnights »

From http://www.sciencedirect.com/science/ar ... 5016303515. A case report. This person's IRLSSG scale rating went from 33/40 to 0/40! He only uses the stimulator before going to bed. So now, in addition to implants that provide deep brain stimulation and implanted morphine pumps, there are also implants for spinal cord stimulation that seem to work for at least some of us. I wouldn't mind trying a spinal cord implant.

Title: Epidural Spinal Cord Stimulation: A Novel Therapy in the Treatment of Restless Legs Syndrome

Background

We report a unique finding of a patient whose restless legs syndrome (RLS) symptoms abated after the placement of a spinal cord stimulator for chronic neuropathic pain. RLS is a common disorder, with many patients unable to find sufficient relief from their symptoms.

Case Description

A patient diagnosed with neuropathic pain who also suffered from RLS symptoms despite medication therapy underwent implantation of a spinal cord stimulator after a successful trial. This patient was interviewed formally about his RLS symptoms immediately before his procedure and at 6 weeks, 6 months, and 2.5 years after the procedure. The patient also completed the International Restless Legs Syndrome Scale questionnaire to objectively quantify the severity of his symptoms. Finally, the patient kept a 5-day journal detailing when the stimulator was in use. The patient reported subjective symptomatic improvement in his RLS symptoms with improved sleep quality and quantity, in addition to improvement in his back pain. The patient's score on the International Restless Legs Syndrome Scale improved after implantation from 33 to 0 on a 40-point scale. Moreover, when asked to keep a journal record of his stimulator use, the patient noted that he only used the stimulator before going to bed to help his RLS symptoms and no longer required any medication for his previous RLS symptoms.

Conclusions

Epidural stimulation may be an additional, alternative, or novel therapy in the treatment of RLS.
Beth - Wishing you a restful sleep tonight
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stjohnh
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Re: Published Research - General Sleep and RLS (WED)

Post by stjohnh »

Interesting, I wonder if the patient had any residual sleep problems?
Blessings,
Holland

mad4mst
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Re: Published Research - General Sleep and RLS (WED)

Post by mad4mst »

Definitely something to keep in mind, and to keep an eye out for further studies and patient results. I am leery of anything implanted in my spine, but if my symptoms were severe, I might consider it.

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

After a few nights of almost no sleep, I want one. Today.
Ann - Take what you need, leave the rest

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Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

badnights
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Re: Published Research - General Sleep and RLS (WED)

Post by badnights »

Ya. I'm ready.
Beth - Wishing you a restful sleep tonight
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Rustsmith
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Re: Published Research - General Sleep and RLS (WED)

Post by Rustsmith »

From ScienceDirect http://www.sciencedirect.com/science/article/pii/S002839081630377X
by César Quiroz, Seema Gulyani, Wan Ruiqian, Jordi Bonaventura, Roy Cutler, Virginia Pearson, Richard P. Allen, Christopher J. Earley, Mark P. Mattson, Sergi Ferré
Title: Adenosine receptors as markers of brain iron deficiency: Implications for Restless Legs Syndrome
Abstract:
Deficits of sensorimotor integration with periodic limb movements during sleep (PLMS) and hyperarousal and sleep disturbances in Restless Legs Syndrome (RLS) constitute two pathophysiologically distinct but interrelated clinical phenomena, which seem to depend mostly on alterations in dopaminergic and glutamatergic neurotransmission, respectively. Brain iron deficiency is considered as a main pathogenetic mechanism in RLS. Rodents with brain iron deficiency represent a valuable pathophysiological model of RLS, although they do not display motor disturbances. Nevertheless, they develop the main neurochemical dopaminergic changes found in RLS, such as decrease in striatal dopamine D2 receptor density. On the other hand, brain iron deficient mice exhibit the characteristic pattern of hyperarousal in RLS, providing a tool to find the link between brain iron deficiency and sleep disturbances in RLS. The present study provides evidence for a role of the endogenous sleep-promoting factor adenosine. Three different experimental preparations, long-term (22 weeks) severe or moderate iron-deficient (ID) diets (3- or 7-ppm iron diet) in mice and short-term (3 weeks) severe ID diet (3-ppm iron diet) in rats, demonstrated a significant downregulation (Western blotting in mouse and radioligand binding saturation experiments in rat brain tissue) of adenosine A1 receptors (A1R) in the cortex and striatum, concomitant to striatal D2R downregulation. On the other hand, the previously reported upregulation of adenosine A2A receptors (A2AR) was only observed with severe ID in both mice and rats. The results suggest a key role for A1R downregulation in the PLMS and hyperarousal in RLS.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

Another study...

http://medicalxpress.com/news/2016-12-g ... -legs.html

Here are two paragraphs from this:

"The researchers identified for the first time areas of the genome that are associated with sleep disturbance - including insomnia and excessive daytime sleepiness - and also discovered novel genetic links with several medical conditions, including restless legs syndrome, schizophrenia and obesity. The strongest genetic association for insomnia symptoms fell within a gene previously linked to restless legs syndrome - a nervous system disorder affecting around 1 in 20 people that leads to a strong urge to move one's legs, which is often worse at night. Other gene regions were important for insomnia, but selectively in either men or women.

The team also identified genetic links between longer sleep duration and schizophrenia risk and between increased levels of excessive daytime sleepiness and measures of obesity (body mass index and waist circumference). The research also suggested that insomnia has shared underlying biology with major depression and abnormal glucose metabolism."
Ann - Take what you need, leave the rest

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ViewsAskew
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8 genes identified as related to sleep disorders

Post by ViewsAskew »

I haven't had time to review this - could be poor research. According to the headline, scientists have identified 8 genes that are associated with sleep disorders as well as metabolic issues. It's at Huff Post - it showed up in my Google Alerts for RLS from one other source, also, but that was a blog.

http://www.huffingtonpost.com/entry/sle ... cdb0febc4e
Ann - Take what you need, leave the rest

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stjohnh
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Re: 8 genes identified as related to sleep disorders

Post by stjohnh »

ViewsAskew wrote:I haven't had time to review this - could be poor research. According to the headline, scientists have identified 8 genes that are associated with sleep disorders as well as metabolic issues. It's at Huff Post - it showed up in my Google Alerts for RLS from one other source, also, but that was a blog.

http://www.huffingtonpost.com/entry/sle ... cdb0febc4e


Article looks ok to me. Technical analysis of self reported sleep symptoms in 150,000 UK people in UK genetics biobank. Identifies genes likely linked to poor sleep, no direct RLS info. Advances sleep research, which is sorely needed. In spite of an incredible amount of reasearch, the actual purpose of sleep is still poorly understood.

Wouldn't it be great if a doctor could just inject a bioengineered virus into us that inserts a regulatory sequence into our DNA turning off some of the "wake up" chemicals we manufacture.
Blessings,
Holland

Rustsmith
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Re: Published Research - General Sleep and RLS (WED)

Post by Rustsmith »

I particularly like this paragraph, which I slightly simplified. As I understand it, MEIS1 is the gene with the strongest ties to RLS. The role of the gene is not known, but there have been guesses that it is tied to the protein responsible for iron transport across the blood brain barrier. This paper seems to be saying that there could also be a tie between MEIS1 and Dr Allen's study of thalmic glutamate issues in RLS. Wouldn't it be great if all this could be tied together in a couple of years so that Holland's comment of a viral correction of our genetic coding could actually result in a cure for RLS due to the MEIS1 gene?

Our strongest association for insomnia symptoms fell within MEIS1, a locus previously associated with RLS in GWAS. Our lead SNP, rs113851554, and the correlated 3′ UTR variant rs11693221 represent the strongest known genetic risk factor for RLS and were identified in MEIS1 sequencing studies following up the original RLS GWAS signal (rs2300478). Conditional analysis suggests that only one underlying signal, detected by the lead SNP rs113851554 in our GWAS, explains the association of all three SNPs with insomnia symptoms. To further investigate the extent of overlap between RLS and insomnia symptoms, we tested a weighted genetic risk score (GRS) for RLS and found that it was also associated with insomnia symptoms with concordant direction of allelic effects (OR (95% CI) = 1.06 (1.05–1.07) per RLS risk allele, P = 1.17 × 10−21). Weighting of the RLS GWAS alleles by SNP effect on periodic limb movements (PLMs) did not substantially alter the overall results. Interestingly, recent data indicating that thalamic glutamatergic activity is increased in RLS provide evidence of an underlying propensity for hyperarousal in RLS, which is also a core feature of insomnia. Future analyses of pairwise bidirectional causal effects for all three traits will be necessary to determine whether shared genetic associations correspond to causality, partial mediation or pleiotropy.


I should also add that I know that I have the MEIS1 gene coding for RLS.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

Thanks to both of you for reading it and verifying that it was a solid study. I was sleep deprived and in a rush, so didn't want to try when I found it. Still sleep deprived, but what else it new???

It really would be fabulous if somehow all of this tied together in a way that was "fixable" by a viral correction!
Ann - Take what you need, leave the rest

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badnights
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Re: Published Research -increased RLS/WED in MS

Post by badnights »

From the journal Multiple Sclerosis and Related Disorders Volume 12, February 2017, Pages 54–58

200 people with MS were randomly chosen, tested for RLS/WED, had MRI of brain and spinal cord, and blood samples for iron parameters, red blood cells, B and D vitamins. 26% of the MS patients had WED/RLS (more than the general population of N. America). Compared to those without WED/RLS, those with it had more spinal cord lesions. There was no correlation between WED/RLS and any of the other things they tested for. They conclude that having spinal lesions in MS increases the risk for WED/RLS.

This is the abstract:

Background

Multiple sclerosis (MS) is connected with higher prevalence of secondary restless legs syndrome/Willis-Ekbom disease (RLS/WED). Aim of this study was to determine risk factor for developing symptoms of RLS in MS patients.

Methods

In cross-sectional study we examined 200 random MS patients. After obtaining informed consents, patients undervent a structured interview based on RLS and MS symptoms and characteristics, demographic, and health-related data. Than we collected results of brain/spinal cord magnetic resonance imaging (MRI). Blood samples were examined for blood count and biochemistry.

Results

From all 200 subjects, 26% were RLS-positives (95% CI: 20–32%). From positive patients, 44% had negative family history for RLS, and developed secondary RLS after onset of MS. Compared to RLS-negatives, the positives had significantly higher prevalence of spinal cord lesions (p=0.01). Presence of spinal pathology was connected with higher risk of RLS development (OR=3.846, 95%CI:1.304-11.346). There were no statistically significant differences in the levels of red blood cells, iron metabolism parameters, or levels of B or D vitamins.

Conclusion

Risk of RLS/WED in MS increases with presence of lesions in spinal cord. The role of decreased dopamine delivery to lower spinal regions as the pathological background must be proved by more detailed research
Beth - Wishing you a restful sleep tonight
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ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

Thanks, Beth.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Post by ViewsAskew »

Restless legs syndrome and cardiovascular diseases: A case-control study

Marion Cholley-Roulleau ,
Sofiene Chenini ,
Séverine Béziat,
Lily Guiraud,
Isabelle Jaussent,
Yves Dauvilliers

PLOS

Published: April 26, 2017
https://doi.org/10.1371/journal.pone.0176552


http://journals.plos.org/plosone/articl ... ne.0176552
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

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