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Mohammadi MM, Raygani AAV, Ghobadi A, Samadzadeh S, Salari N. Effect of Near-Infrared Light Therapy Based on Acupoints on the Severity of Restless Legs Syndrome in Patients Undergoing Hemodialysis: A Single-Blind, Randomized Controlled Trial. Clin Med Res 2018; 16:1-8. [PMID: 29776916 PMCID: PMC6108511 DOI: 10.3121/cmr.2018.1389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/15/2017] [Accepted: 01/15/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a common disorder in hemodialysis patients. The present study was conducted to determine the effect of near-infrared (NIR) light therapy given to acupoints on the severity of RLS in patients undergoing hemodialysis. METHODS This single-blind, randomized controlled trial was performed on 60 hemodialysis patients with RLS. Participants who met the inclusion criteria were randomly assigned to an intervention group (n = 30) or a control group (n = 30). Data were collected using the International Restless Legs Syndrome Rating Scale (IRLSRS) and demographic information questionnaire. The intervention group received 12 sessions of NIR light therapy (940 nm) to acupoints in the legs and feet during hemodialysis three times a week, while the control group received sham treatment. Data were analyzed using SPSS version 22 software. RESULTS The results indicated that there were statistically and clinically significant differences between the intervention and control groups at the end of the intervention sessions (P < 0.001, mean difference [MD] = 3.8). However, after the treatment was discontinued, the difference was not clinically significant (MD = 2.4). In the within-group compression, the mean RLS scores of the intervention group decreased significantly during the intervention sessions (MD = 3.2, P < 0.001); however, after the treatment was discontinued, the difference was not clinically significant (MD = 1.67). CONCLUSION The present study showed that the application of NIR light to acupoints in the legs and feet was as an effective treatment for attenuating the symptoms of RLS in hemodialysis patients.
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Affiliation(s)
- Mohammad Mehdi Mohammadi
- School of Nursing and Midwifery, Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Ali Akbar Vaisi Raygani
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran. ghobadi57.
| | - Akram Ghobadi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran. ghobadi57. . ghobadi57
| | - Soheila Samadzadeh
- Rehabilitation and Sport Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Nader Salari
- Department of Biostatistics and Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Abstract
Restless legs syndrome (RLS) is a disorder characterized by an irresistible urge to move the legs during rest, usually accompanied by uncomfortable sensations in the affected extremity or extremities. RLS can manifest at any age but prevalence increases with advancing age. This article describes the symptoms of RLS, associated comorbidities, and how to diagnose and manage RLS.
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Restless legs syndrome: a rarity in the Nigerian pregnant population? Sleep Med 2018; 43:47-53. [PMID: 29482812 DOI: 10.1016/j.sleep.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/15/2017] [Accepted: 01/04/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The prevalence of RLS in pregnancy is higher when compared with the general population however it remains unknown among indigenous black Africans. Available data indicate that RLS is uncommon in sub-Saharan Africa. We embarked on this study to determine the prevalence and characteristics of RLS in an antenatal clinic sample of Nigerian pregnant women compared with a primary care sample of non-pregnant women. METHODS A total of 310 pregnant women and non-pregnant women filled out a questionnaire which incorporated the 2014 minimal criteria of the International Restless Legs Syndrome Study Group. Demographic and clinical data, including sleep duration and samples for blood hemoglobin concentration and urinalysis were obtained. RESULTS The mean ages of the pregnant and non-pregnant women were 24.9 ± 5.6 years and 23.6 + 5.4 years, respectively (p = 0.003). There was no case of RLS found among pregnant women while five (1.6%) of the non-pregnant women fulfilled the criteria for RLS. Overall, the prevalence report of RLS symptoms was associated with lower mean habitual nocturnal sleep duration (p < 0.05) coffee (p = 0.013) and kola nut (0.023) consumption, report of leg cramps (p < 0.001) and proteinuria (p = 0.047), Report of leg cramps and proteinuria were independently associated with RLS. CONCLUSION The prevalence of restless legs syndrome is low among women of child-bearing age in the Nigerian population and may be lower in pregnancy. Report of leg cramps and proteinuria are independently associated with RLS.
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González-Platas M, González-Platas J, Bermúdez-Hernández M, Pérez-Martín MY, Croissier-Elías C, Pérez-Lorensu PJ. Low Prevalence of Sleep Disorders in Demyelinating Disease in a Northern Tenerife Population. J Clin Sleep Med 2016; 12:805-11. [PMID: 26951408 DOI: 10.5664/jcsm.5874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 01/27/2016] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES Sleep disorders are seen in patients with demyelinating disease (DD) more often than in the general population. Combination of physical and psychological factors such as pain, spasms, nocturia, depression, anxiety, or medication effects could contribute to sleep disruption. Frequently, these disturbances have a major impact on health and quality of life of patients. The aim of this study was to estimate the prevalence of sleep disorders in patients seen in the DD consultation. METHODS 240 patients; mean age 43 years, 187 women; 163 patients with multiple sclerosis (MS): 144 relapsing-remitting, 19 progressive forms, 36 clinically isolated syndrome, 26 radiological isolated syndrome, and 15 patients with others DD. All participants completed questionnaires: Pittsburgh, Epworth, and Stanford scales, indirect symptoms of RLS and Obstructive Sleep Apnea, Fatigue Severity Scale, and Multiple Sclerosis Quality of Life-54. RESULTS Moderate/severe insomnia 12.5%, OSA 5.8%, RLS 9.6% (confirmed 3 cases), narcolepsy 0, fatigue (> 4) 24.6%. Physical QoL 66.6 ± 19.6, Mental QoL 66.1 ± 21.9. Patients with an established diagnosis showed higher scores on insomnia compared to the group of CIS and RIS (F = 3.85; p = 0.023), no differences were in the other parameters. Fatigue showed high correlation with insomnia (r = 0.443; p < 0.001), RLS (r = 0.513; p < 0.001), and sleepiness (r = 0.211; p = 0.001). None of the variables included in the regression model were shown to be predictors of Physical and Mental QoL. CONCLUSIONS A high percentage of our sample sleeps well. Emphasize the low prevalence of sleep disorders (insomnia, fatigue, RLS, etc). We detected an overestimation in the RLS questionnaire and the low QoL recorded.
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Affiliation(s)
| | - Javier González-Platas
- Faculty of Mathematics and Physics, University of La Laguna, Campus Anchieta, La Laguna, Spain
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Cikrikcioglu MA, Sekin Y, Halac G, Kilic E, Kesgin S, Aydin S, Ozaras N, Akan O, Celik K, Hamdard J, Zorlu M, Karatoprak C, Cakirca M, Kiskac M. Reduced bone resorption and increased bone mineral density in women with restless legs syndrome. Neurology 2016; 86:1235-41. [PMID: 26920357 DOI: 10.1212/wnl.0000000000002521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/25/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate bone resorption and formation markers as well as bone mineral density in women with restless legs syndrome (RLS). METHODS This was a prospective cross-sectional case-control study involving drug-naive women with RLS and age- and body mass index (BMI)-matched female controls. Routine blood analyses, markers of bone formation, procollagen 1 n-terminal peptide, bone resorption, c-telopeptide of type 1 collagen (CTX), sclerostin, and bone mineral density (BMD) were compared between the 2 groups. Pregnant or breastfeeding women and individuals with comorbidities other than iron deficiency, type 2 diabetes mellitus, or hypertension were excluded. RESULTS A significant increase in lumbar BMD was found among 78 women with RLS as compared to 78 age- and BMI-matched controls (p = 0.001). The proportion of patients with osteopenia as defined by a lumbar T score was significantly lower among patients with RLS (p = 0.040). CTX and sclerostin were significantly lower in patients with RLS (p = 0.006 and p = 0.011, respectively), as were the levels of 25-hydroxy vitamin D3, calcemia, and free T3 (p = 0.017, p = 0.017, and p = 0.002, respectively). CONCLUSIONS Despite lower 25-hydroxy vitamin D3, patients with RLS had lower bone resorption markers, higher lumbar BMD, and lower frequency of lumbar osteopenia. As patients with RLS make movements night and day to decrease the severity of their symptoms, they unconsciously perform exercise, which may potentially explain the better bone profile among patients with RLS than in controls.
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Affiliation(s)
- Mehmet Ali Cikrikcioglu
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.
| | - Yahya Sekin
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Gulistan Halac
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Elif Kilic
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Siddika Kesgin
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Senay Aydin
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Nihal Ozaras
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Onur Akan
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Kenan Celik
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Jamshid Hamdard
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Mehmet Zorlu
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Cumali Karatoprak
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Mustafa Cakirca
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
| | - Muharrem Kiskac
- From the Departments of Internal Medicine (M.A.C., Y.S., K.C., J.H., M.Z., C.K., M.C., M.K.), Neurology (G.H.), Biochemistry (E.K., S.K.), and Physical Medicine and Rehabilitation (N.O.), Bezmialem Vakif University Medical Faculty, Fatih; Department of Neurology (S.A.), Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Zeytinburnu; and Department of Neurology (O.A.), Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey
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Guffey JS, Motts S, Barymon D, Wooten A, Clough T, Payne E, Henderson M, Tice N. Using near infrared light to manage symptoms associated with restless legs syndrome. Physiother Theory Pract 2016; 32:34-44. [DOI: 10.3109/09593985.2015.1087613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Terzi R, Yılmaz Z. Restless leg syndrome and associated factors in patients with paralytic poliomyelitis. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Rabia Terzi
- Department of Physical Medicine and Rehabilitation; Kocaeli Derince Education and Research Hospital; Kocaeli Turkey
| | - Zahide Yılmaz
- Department of Neurology; Kocaeli Derince Education and Research Hospital; Kocaeli Turkey
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Celik K, Cikrikcioglu MA, Halac G, Kilic E, Ayhan S, Ozaras N, Yildiz K, Yildiz RS, Zorlu M, Karatoprak C, Cakirca M, Kiskac M. Serum endocan levels in women with restless legs syndrome. Neuropsychiatr Dis Treat 2015; 11:2919-25. [PMID: 26640378 PMCID: PMC4657799 DOI: 10.2147/ndt.s92771] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. METHODS A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. RESULTS Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P<0.001). 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.
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Affiliation(s)
- Kenan Celik
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Mehmet A Cikrikcioglu
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Gulistan Halac
- Department of Neurology, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Elif Kilic
- Department of Biochemistry, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Siddika Ayhan
- Department of Biochemistry, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Nihal Ozaras
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Kemal Yildiz
- Department of Internal Medicine, Private Medicana International Istanbul Hospital, Beylikdüzü, Istanbul, Turkey
| | - Rabia S Yildiz
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Mehmet Zorlu
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Cumali Karatoprak
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Mustafa Cakirca
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
| | - Muharrem Kiskac
- Department of Internal Medicine, Medical Faculty, Bezmialem Vakif University, Fatih, Turkey
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Giorgi L, Asgharian A, Hunter B. Ropinirole in patients with restless legs syndrome and baseline IRLS total scores ≥ 24: efficacy and tolerability in a 26-week, double-blind, parallel-group, placebo-controlled study followed by a 40-week open-label extension. Clin Ther 2013; 35:1321-36. [PMID: 23938061 DOI: 10.1016/j.clinthera.2013.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 05/06/2013] [Accepted: 06/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND As with studies of other dopamine agonists, previously reported studies of ropinirole in restless legs syndrome (RLS) recruited patients with baseline International Restless Legs Scale (IRLS) total scores ≥ 15. The reported pooled analyses of clinical trials data suggest benefits of ropinirole in patients with IRLS total scores ≥ 24, but the effects of ropinirole have not been prospectively evaluated in this patient population. OBJECTIVE The goal of this study was to evaluate the efficacy and tolerability of ropinirole in patients with RLS and baseline IRLS total scores ≥ 24. This study was conducted in part to fulfill a postlicensing commitment between the maker of ropinirole and the European Union's Committee for Medicinal Products for Human Use. METHODS The protocol for this study comprised a randomized, double-blind, placebo-controlled, parallel-group, 26-week phase during which adults with baseline IRLS total scores ≥ 24 received a ropinirole dose from 0.25 to 4 mg (n = 197) or placebo (n = 207) followed by a 40-week, open-label phase during which all patients (n = 269) received ropinirole. The primary efficacy end point was the change from baseline in the IRLS total score at week 12. Tolerability measures included the incidence of adverse events, augmentation, and early morning rebound. Due to the possibility of a treatment-by-center group interaction (P = 0.04) in the IRLS analysis, further efficacy exploratory analyses were performed to assess the impact of the interaction on the overall assessment of efficacy. RESULTS Demographic characteristics were comparable between groups (mean [SD] age: placebo, 56.1 [11.38] years; ropinirole, 56.5 [11.92] years; 63% female in both groups). All of the patients in the ropinirole group were white; 99% of the placebo group was white. Ropinirole was significantly better than placebo for change from baseline in the IRLS total score during both short- and long-term treatment, with mean treatment differences of -2.1 (P = 0.039) and -2.5 (P = 0.023) for weeks 12 and 26, respectively. A statistically significant treatment by center group interaction was observed (P = 0.040) for the change from baseline in IRLS total score, indicating variation of treatment effects among center groups; however, all center groups showed an improvement from baseline at both week 12 and week 26 for the ropinirole immediate-release group and the placebo group. The incidences of augmentation and early morning rebound were ≤ 4% for ropinirole. The adverse event profile of ropinirole was consistent with that reported in previous clinical trials. CONCLUSIONS In this subset of patients with RLS and a baseline IRLS total score ≥ 24, ropinirole was effective and well tolerated compared with placebo. The incidence of augmentation and early morning rebound in this study was low.
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Acute and non-acute lower extremity pain in the pediatric population: part II. J Pediatr Health Care 2012; 26:216-30. [PMID: 22526001 DOI: 10.1016/j.pedhc.2012.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 01/27/2012] [Accepted: 01/30/2012] [Indexed: 11/21/2022]
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Caminero A, Bartolomé M. Sleep disturbances in multiple sclerosis. J Neurol Sci 2011; 309:86-91. [DOI: 10.1016/j.jns.2011.07.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Revised: 07/11/2011] [Accepted: 07/12/2011] [Indexed: 01/12/2023]
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Guerreiro TM, Nishikawa DRC, Ferreira LC, Melo HAD, Prado RCPD. Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 68:869-72. [PMID: 21243243 DOI: 10.1590/s0004-282x2010000600007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 05/12/2010] [Indexed: 11/22/2022]
Abstract
Restless legs syndrome (RLS) is a neurological disorder that responds to dopaminergic drugs, indicating a common pathophysiology with Parkinson's disease (PD). The prevalence of RLS was estimated in a group of PD patients and its clinical and biochemical characteristics were analysed. Forty-eight patients with PD were evaluated into two groups, with and without RLS. Clinical characteristics assessed in both groups were age, gender, duration of PD, Hoehn and Yahr, and Schwab and England scales. Laboratory variables such as hemoglobin, s-iron, s-ferritin and creatinine were obtained. The prevalence of RLS was 18.75%. No significant differences regarding clinical variables and biochemical parameters were observed. The high prevalence of RLS found in PD patients suggests the concept of a common etiological link and it seems that secondary causes did not play a central role in the pathophysiology of RLS in this group of parkinsonian patients.
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Yang Q, Li L, Chen Q, Foldvary-Schaefer N, Ondo WG, Wang QK. Association studies of variants in MEIS1, BTBD9, and MAP2K5/SKOR1 with restless legs syndrome in a US population. Sleep Med 2011; 12:800-4. [PMID: 21925394 PMCID: PMC3514407 DOI: 10.1016/j.sleep.2011.06.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 06/17/2011] [Accepted: 06/17/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND A genome-wide association study (GWAS) identified significant association between variants in MEIS1, BTBD9, and MAP2K5/SKOR1 and restless legs syndrome (RLS). However, many independent replication studies are needed to unequivocally establish a valid genotype-phenotype association across various populations. To further validate the GWAS findings, we investigated three variants, rs2300478 in MEIS1, rs9357271 in BTBD9, and rs1026732 in MAP2K5/SKOR1 in 38 RLS families and 189 RLS patients/560 controls from the US for their association with RLS. METHOD Both family-based and population-based case-control association studies were carried out. RESULTS The family-based study showed that SNP rs1026732 in MAP2K5/SKOR1 was significantly associated with RLS (P=0.01). Case-control association studies showed significant association between all three variants and RLS (P=0.0001/OR=1.65, P=0.0021/OR=1.59, and P=0.0011/OR=1.55 for rs2300478, rs9357271, and rs1026732, respectively). CONCLUSION Variants in MEIS1, BTBD9, and MAP2K5/SKOR1 confer a significant risk of RLS in a US population.
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Affiliation(s)
- Qinbo Yang
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, OH, USA
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, P. R. China
- Department of Molecular Medicine, CCLCM of Case Western Reserve University, Cleveland, OH, USA
| | - Lin Li
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, OH, USA
- Department of Molecular Medicine, CCLCM of Case Western Reserve University, Cleveland, OH, USA
| | - Qiuyun Chen
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, OH, USA
- Department of Molecular Medicine, CCLCM of Case Western Reserve University, Cleveland, OH, USA
| | - Nancy Foldvary-Schaefer
- Center for Sleep Medicine, Neurological Institute, Cleveland Clinic, OH, USA
- Department of Molecular Medicine, CCLCM of Case Western Reserve University, Cleveland, OH, USA
| | - William G. Ondo
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Qing Kenneth Wang
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, OH, USA
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, P. R. China
- Center for Sleep Medicine, Neurological Institute, Cleveland Clinic, OH, USA
- Department of Molecular Medicine, CCLCM of Case Western Reserve University, Cleveland, OH, USA
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Yaltho TC, Ondo WG. The use of gabapentin enacarbil in the treatment of restless legs syndrome. Ther Adv Neurol Disord 2011; 3:269-75. [PMID: 21179617 DOI: 10.1177/1756285610378059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Restless legs syndrome (RLS) is a common sleep-related neurological disorder that is characterized by the urge to move, worsening at rest, improvement with activity, and worsening in the evening and night. Dopamine agonists are usually the first-line therapy. Other agents including benzodiazepines, narcotics, and anticonvulsants have been used to treat RLS. Gabapentin has been shown to improve RLS in a small number of clinical studies, but is limited by its short half-life and variable bioavailability. Gabapentin enacarbil is a novel prodrug of gabapentin designed to overcome these pharmacokinetic limitations. In vitro and in vivo studies have demonstrated that gabapentin enacarbil has improved absorption, bioavailability and pharmacokinetics compared with gabapentin. Phase II and III studies have demonstrated that gabapentin enacarbil is generally well tolerated and is useful in the treatment of RLS.
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Affiliation(s)
- Toby C Yaltho
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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Cannon PR, Larner AJ. Migraine and restless legs syndrome: is there an association? J Headache Pain 2011; 12:405-9. [PMID: 21660429 PMCID: PMC3139066 DOI: 10.1007/s10194-011-0357-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 05/25/2011] [Indexed: 11/28/2022] Open
Abstract
Occasional clinical reports have suggested a link between migraine and restless legs syndrome. We undertook a systematic review of the evidence, which supports this association, and consider possible shared pathogenic mechanisms and the implications for current clinical practice.
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Affiliation(s)
- Paul R. Cannon
- Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool, L9 7LJ UK
| | - Andrew J. Larner
- Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool, L9 7LJ UK
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Ediz L, Hiz O, Toprak M, Ceylan MF, Yazmalar L, Gulcu E. Restless Legs Syndrome in Behçet's Disease. J Int Med Res 2011; 39:759-65. [DOI: 10.1177/147323001103900307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The prevalence of restless legs syndrome (RLS) and its association with the clinical features of Behçet's disease (BD) has not previously been elucidated. The inflammatory character, central nervous system involvement and neuropathies of BD led to this investigation of RLS risk in BD patients. A total of 116 BD patients and 104 healthy control subjects were included; seven BD patients were excluded because of concurrent diseases, pregnancy or alcohol misuse that might cause RLS symptoms, and the remaining 109 BD patients were included in the analysis. The prevalence of RLS was significantly higher in patients with BD (32/109; 29.4%) than in controls (5/104; 4.8%). No significant differences were found between BD patients with and without RLS with regard to the clinical features of BD. RLS severity positively correlated with age in BD patients. In conclusion, BD-related RLS should be considered in symptomatic RLS secondary to rheumatological disorders and BD patients should be examined for RLS. Further studies are needed to clarify the pathogenetic mechanisms underlying BD-related RLS.
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Affiliation(s)
- L Ediz
- Department of Physical Medicine — Rehabilitation and Rheumatology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - O Hiz
- Department of Physical Medicine — Rehabilitation and Rheumatology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - M Toprak
- Department of Physical Medicine — Rehabilitation and Rheumatology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - MF Ceylan
- Department of Orthopaedics, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - L Yazmalar
- Department of Physical Medicine — Rehabilitation and Rheumatology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - E Gulcu
- Department of Physical Medicine — Rehabilitation and Rheumatology, Yuzuncu Yil University Medical Faculty, Van, Turkey
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Florindo D, Daniela C, Giulio C, Vittorio P, Gabriella M, Vincenzo T, Eliana M, Gerardo C, Gennaro B. Cluster headache patients are not affected by restless legs syndrome: an observational study. Clin Neurol Neurosurg 2011; 113:308-10. [PMID: 21255910 DOI: 10.1016/j.clineuro.2010.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 11/15/2010] [Accepted: 12/09/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the presence of Restless Legs Syndrome (RLS) in Cluster Headache (CH) patients compared to headache-free controls. DESIGN AND SETTING Cross-sectional case-control study of CH patients presenting at tertiary headache centers over the period January-December 2008. PATIENTS AND PARTICIPANTS Fifty consecutive patients (6 women and 44 men) of mean age of 39.7 year (standard deviation 10.9) with episodic or chronic CH diagnosed according to ICHD-II criteria and 50 headache-free subjects matched by age and sex were recruited. RESULTS None of the CH patients had RLS. Six (12%) headache-free controls had RLS. CONCLUSIONS Our data indicate no probable relationship between CH and RLS. However, since both conditions have a circadian rhythm and are associated with altered melatonin secretion, we conjecture that reduced nocturnal melatonin in CH likely allows sustained dopaminergic activity which could be protective against RLS in CH patients.
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Yilmaz K, Kilincaslan A, Aydin N, Kor D. Prevalence and correlates of restless legs syndrome in adolescents. Dev Med Child Neurol 2011; 53:40-7. [PMID: 20875044 DOI: 10.1111/j.1469-8749.2010.03796.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to determine the prevalence and correlates of restless legs syndrome (RLS) in adolescents. METHOD A sleep questionnaire aimed at identifying 'definite' RLS criteria (also including the Strengths and Difficulties Questionnaire and the Epworth Sleepiness Scale) was completed by 3304 high school adolescents aged 15 to 18 years (49% male; 51% female) in Gaziantep, Turkey. The diagnosis of RLS was confirmed by face-to-face or phone interviewing. The χ² or Student's t-test and logistic regression tests were used for statistical evaluation. RESULTS 'Definite' RLS was diagnosed in 3.6% of participants. RLS symptoms were reported to occur on more than one occasion per week (frequent RLS) in 2% of participants and to make it to difficult to fall asleep or stay asleep (RLS with sleeping difficulty) in 1.7%. The prevalence of the combination of frequent symptoms and sleeping difficulty was 0.8%. Logistic regression analysis revealed that RLS was independently associated with nocturnal bed-wetting (4.2% vs 0.8%; p=0.004), sleeping difficulty (47% vs 32%; p=0.011), Epworth Sleepiness Scale score (4.9 vs 3.9; p=0.036), hyperactivity/inattention (25% vs 14%; p=0.049), awakening with discomfort in the legs (51% vs 30%; p<0.001), and parents with RLS-implying symptoms (56% vs 38%; p=0.006). RLS with sleeping difficulty was associated with hyperactivity/inattention (p=0.007); frequent RLS was associated with arm restlessness (p=0.006). INTERPRETATION 'Definite' RLS is not rare in adolescents; furthermore, it may be accompanied by several comorbid conditions that can impair quality of life in adolescents.
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Affiliation(s)
- Kutluhan Yilmaz
- Faculty of Medicine, Department of Paediatrics, Gaziantep University, Gaziantep, Turkey.
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Mitchell UH, Myrer JW, Johnson AW, Hilton SC. Restless legs syndrome and near-infrared light: An alternative treatment option. Physiother Theory Pract 2010; 27:345-51. [DOI: 10.3109/09593985.2010.511440] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mitchell UH. Use of near-infrared light to reduce symptoms associated with restless legs syndrome in a woman: a case report. J Med Case Rep 2010; 4:286. [PMID: 20731851 PMCID: PMC2936319 DOI: 10.1186/1752-1947-4-286] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 08/23/2010] [Indexed: 11/29/2022] Open
Abstract
Introduction We describe a potential new treatment option for patients suffering from restless legs syndrome. Contemporary treatment for restless legs syndrome consists mostly of dopaminergic drugs that leave some patients feeling nauseated and dizzy. A non-invasive, drug-free option would open new doors for patients suffering from restless legs syndrome. Case presentation A 69-year-old Caucasian woman met International Restless Legs Syndrome Study Group criteria for the diagnosis of restless legs syndrome. She had been afflicted with restless legs syndrome for over 30 years and tried many of the available pharmaceutical remedies without success. For this study she received 30-minute treatment sessions with near-infrared light, three times a week for four weeks. The restless legs syndrome rating scale was used to track symptom changes; at baseline she scored "27" on the 0 to 40 point scale, which is considered to be "severe". Our patient was almost symptom free at week two, indicated by a score of "2" on the rating scale. By week four she was completely symptom free. The symptoms slowly returned during week three post treatment. Conclusions The findings suggest that near-infrared light may be a feasible method for treating patients suffering from restless legs syndrome. Undesirable side-effects from medication are non-existent. This study might revive the neglected vascular mechanism theory behind restless legs syndrome and encourage further research into this area.
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Affiliation(s)
- Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA.
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