Sunday, August 14, 2022

Is Restless Leg Syndrome Related To Parkinson’s Disease

Detections Of The Levels Of Neurotransmitters In Csf And Serum

Pain in Legs in Parkinsonism with Dr. Abdul Rana Neurologist

The levels of neurotransmitters, including DA, 5-HT, Ach and NE in CSF and serum from PD patients, were measured by high-performance liquid chromatography. Phenomenex 150×2mm, 150×3mm chromatographic column, and liquid chromatography tandem mass spectrometry 6410 instrument were from Agilent , and standard samples were from Sigma .

Abnormalities Of Iron Metabolism

Iron deficiency, even at a level too mild to cause anemia, has been linked to RLS in some people. Some research suggests that RLS in some people may be due to a problem with getting iron into cells that regulate dopamine in the brain. Some studies have reported RLS in a quarter to a third of people with low iron levels.

When Should I See A Doctor About Restless Legs Syndrome

You should see a doctor to confirm the diagnosis of RLS and to exclude other conditions that may resemble RLS. The doctor can treat associated problems like iron deficiency.

If you have RLS, you should also see a doctor if you are:

  • Feeling depressed or anxious
  • Having trouble concentrating

You dont have to wait until one of these things happens. If you just want to feel better, see your doctor.

Other Conditions Associated With Restless Legs Syndrome

The following medical conditions are also associated with RLS, although the relationships are not clear. In some cases, these conditions may contribute to RLS. Others may have a common cause, or they may coexist due to other risk factors:

  • Osteoarthritis . About three-quarters of patients with RLS also have osteoarthritis, a common condition affecting older adults.
  • Varicose veins. Varicose veins occur in about 1 in 7 patients with RLS.
  • Obesity.
  • Diabetes. People with type 2 diabetes may have higher rates of secondary RLS. Nerve pain related to their diabetes cannot fully explain the higher rate of RLS.
  • Hypertension .
  • Psychiatric disorders, such as depression.

The Link Between Rls And Parkinsons: Dopamine Agonists

Dr. Poceta is a Consultant in Neurology and Sleep Disorders in the Division of Neurology, Scripps Clinic, La Jolla, and the Scripps Clinic Sleep Center. His current interests include organized medicine and Internet medicine.

What Are Common Signs And Symptoms Of Restless Legs

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Want To Learn More About The Latest Research In Parkinsons Disease Ask Your Questions In Our Research Forum

Having RLS in 2002 and/or 2008 was associated with a higher risk of constipation in 2012, compared with controls. Only individuals who had RLS in both 2002 and 2008 showed higher odds of having possible RBD alone, and both constipation and possible RBD in 2012, indicating a potential association between continuous/recurrent RLS and , according to the researchers.

They cautioned that constipation is a relatively non-specific Parkinsons symptom and may not indicate a direct link between RLS and Parkinsons.

No differences were found between olfactory scores of men with or without RLS. However, the team noted that olfactory scores were only available from a subset of participants. Additionally, the timing of the smell sense analysis may also have influenced this result, since a loss of sense of smell has been reported as a relatively late symptom in the early stages of Parkinsons compared with RBD and constipation, they said.

We assessed the association between RLS and prodromal signs, but not between RLS and incidence. However, our focus was on identifying whether RLS is an early indicator of the underlying common disease process in , the authors wrote.

The findings warrant future studies for RLS and Parkinsons incidence in the long-term, they said.

Among the studys limitations, the authors mentioned that the link between Parkinsons and RLS may differ by gender, since women, although they have a reduced risk for Parkinsons, are more susceptible to RLS.

Interrupted Sleep: Exploring Links Between Parkinsons Disease And Restless Leg Syndrome

What The Heck Is Restless Leg Syndrome?

Restless Legs Syndrome and Parkinsons disease have interesting dopamine connections. Some Parkinsons pain may actually be restless legs or arms. Could changes in RLS treatment over the past few years be relevant to getting a good nights sleep with PD?

To those unfamiliar with the condition, the terminology Restless Legs makes it difficult to accept as the serious condition that it is. Whenever I hear the term Restless Legs Syndrome, my brain thinks ants in my pants. I picture myself back in elementary school, being forced to sit at a desk, when Id rather be running around outside. That is far from being an accurate description of this medical condition.

The USA National Institutes of Health describes RLS as follows:

I know the feeling all too well. Sitting anywhere for more than an hour or so where I cant stretch/straighten out my legs leads to extreme pain that can usually be walked off with just a few minutes of movement. Gymnasium bleachers are the worst for me. I used to prefer bulkhead rows on airplanes, but now they can be painful because I cannot stretch my legs into the space under the seat in front of me. Movie theaters generally arent a problem, as the old theaters have been replaced by megaplexes that are focused more on comfy recliner seats. By contrast, traditional theatre can be torturealthough an aisle seat usually provides me with enough wiggle room to endure until intermission.

What causes RLS?

According to the NIH:

Suggested further reading:

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Cbd May Support Healthy Stress Levels

Stress is a common trigger for restless leg syndrome. Many patients report experiencing more severe symptoms during periods of stress in their lives, which is why many natural-based treatments for RLS involve stress management.

While stress is an important biological process in our central nervous system designed for survival and motivation, too much stress is bad for us.

CBD has been down to activate the 5-HT1A serotonin receptors in the CNS, which moderates anxiety and nausea . CBD oil in high doses has also been shown to affect GABA activity in the brain .

GABA is a neurotransmitter that counteracts the stress response brought on by cortisol. Higher levels of GABA in the brain helps to calm the central nervous system to enter the rest-and-digest mode.

Restless Legs Syndrome And Leg Motor Restlessness In Parkinsons Disease

Keisuke Suzuki

1Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan

2School of Nursing, Dokkyo Medical University, Tochigi, Japan

3Department of Neurology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan

Academic Editor:

2. The Diagnosis of RLS

IRLSSG Consensus Diagnostic Criteria for Restless Legs Syndrome/Willis-Ekbom Disease

Essential Diagnostic Criteria . Consider the following:An urge to move the legs is usually but not always accompanied by, or felt to be caused by, uncomfortable and unpleasant sensations in the legs.The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting.The urge to move the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.The urge to move the legs and any accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening or night than during the day.The occurrence of the above features is not solely accounted for as symptoms primary to another medical or a behavioral condition .

3. The Pathophysiology of RLS

4. Imaging in RLS

Copyright

Check Out David Wimbles Site Http://wwwrlcurecom/ For More Info On Rls

The current study assessed the prevalence and the clinical characteristics of RLS in a cohort of AD patients.

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Characteristics Of Restless Leg Syndrome

There are certain features of RLS that make it a unique and specific disorder.

  • The hallmark of RLS is a feeling of restlessness, usually in the legs. The restlessness is often accompanied by additional sensations such as tingling, creepy-crawly or electric sensations, usually located in the legs. The symptoms are usually not restricted to the toes or feet, as in peripheral neuropathy, but rather are present more generally in the legs, often the calves or thighs.
  • The restlessness is worse when the person is at rest or not moving. This feature makes it hard for people with RLS to get to sleep and can also interfere with the ability to sit still in order to read, relax, or do desk work.
  • Symptoms are improved with moving, particularly walking. Unfortunately, the relief lasts only as long as the movement continues, which makes some people pace the floor for hours when the condition is severe. Besides walking, sometimes providing other stimuli to the legs is helpful, such as rubbing, massage, or stretching.
  • RLS can be accompanied by a related disorder called Periodic Limb Movements of Sleep which are repetitive leg movements that occur during sleep.
  • Environmental And Dietary Factors

    Living with Parkinson’s-restless leg syndrome 6 years after diagnosis

    The following environmental and dietary factors can trigger or worsen RLS:

    • Iron deficiency. People who are deficient in iron are at risk for RLS, even if they do not have anemia.
    • Folic acid or magnesium deficiencies.
    • Smoking.
    • Caffeine. Coffee drinking is specifically associated with PLMD.
    • Stress.

    Drugs that may worsen or provoke RLS include:

    • Antidepressants
    • Calcium channel blockers
    • Metoclopramide
    • Antihistamines
    • Spinal anesthesia

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    The Takeaway: Can Cbd Oil Help With Restless Leg Syndrome

    The research specific to CBD for restless leg isn’t sufficient, but we can expect more pre-clinical and clinical studies to investigate. Despite this, many people are still turning towards hemp-based cannabinoid use to improve one’s quality of life living with RLS and other movement disorders.

    If you plan on using CBD for RLS, please check with your doctor first to ensure it’s safe and recommended for you.

    The best treatments for RLS combine a mix of lifestyle changes, natural therapies, and doctor-prescribed medications to help alleviate severe symptoms. For example, RLS patients find that foot baths, massages, stress reduction therapies, and avoiding caffeine and alcohol help their condition.

    You can check out our blog for more articles like this and how you can use CBD to support your health and wellness. You can also sign up to our Insider Scoop email list to receive industry updates straight to your inbox with exclusive Neurogan product offers.

    Resources:

  • Picchietti, M. A., & Picchietti, D. L. . Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis, and treatment. Sleep medicine, 11, 643-651.
  • Allen, R. . Dopamine and iron in the pathophysiology of restless legs syndrome . Sleep medicine, 5, 385-391.
  • Renard, J., Norris, C., Rushlow, W., & Laviolette, S. R. . Neuronal and molecular effects of cannabidiol on the mesolimbic dopamine system: Implications for novel schizophrenia treatments. Neuroscience & Biobehavioral Reviews, 75, 157-165.
  • Is Rls More Common In Pd

    But what about the other possibility? Do patients with PD have an increased risk of RLS over the general population? Is it the same RLS as the person without PD has, or is it different? These questions have been difficult to answer. Of course, since PD affects about 1.5% of the elderly, and RLS in about 4-10% of the population, there will be some coincidental overlap. In addition to this however, patients with PD can have sensations that feel like RLS when their dose of dopamine medication is wearing off. These sensations are not truly RLS since they do not have the key features of RLS described above and fluctuate with medication timing, but they can be easily confused with RLS by the person with PD.

    Studies of people with PD that assess for RLS and compare to a control group are hindered by the fact that the majority of patients with significant PD are under treatment with medications that affect RLS. Over the years, there have been multiple studies investigating whether RLS is more common in PD than in the general population. Different studies come to different conclusions. Studies conducted in which a group of people with PD are directly compared to a group of people without PD typically show that RLS is more common in PD than the general population.

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    Fatigue Sleep Difficulties And Restless Legs

    Although Parkinsons is classified as a movement disorder, it can affect people in various different ways. Sometimes the non-movement symptoms can be more troublesome and can have a bigger impact on the daily life of someone living with Parkinsons.

    Some of the more common non-movement symptoms of Parkinsons are:

    Is It Difficult To Diagnose Restless Legs Syndrome In People With Parkinson’s

    (PDF) Restless legs syndrome in Parkinson

    Because there isn’t a specific test for restless legs syndrome, it can be difficult to diagnose the condition. Sometimes symptoms only happen briefly or from time to time.

    Also, the condition can cause discomfort at night-time and this can be mistaken for arthritis in people with Parkinson’s.

    Another reason why a person with Parkinson’s may experience disturbed sleep is due to dyskinesia. Dyskinesia is involuntary movements sometimes seen in people with Parkinson’s. If you’re concerned about this, speak to your GP, specialist or Parkinson’s nurse.

    Your treatment will depend on how severe your symptoms are and what may be causing them.

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    What Impact Does Dbs Surgery For Pd Have On Rls

    The emergence of RLS after subthalamic nucleus deep brain stimulation in patients with PD has been reported . Eleven of 195 patients with STN DBS reported new problematic symptoms of RLS after surgery. The mean reduction in antiparkinsonian medication was 74%. The authors suggested that reduction of anti-parkinsonian medication during STN DBS may unmask symptoms of RLS. However, a recent prospective study of 17 patients undergoing STN DBS identified 6 patients with RLS with a mean IRLSSG rating score of 23 preoperatively. Postoperative scores at 4 weeks and 6 months were significantly improved at 14.8 and 13.8 respectively. None of the patients developed RLS postoperatively .

    Demographic Information Of Pd

    The demographic variables were compared between PD-RLS and PD-NRLS groups, and the data showed a significantly longer disease duration in PD-RLS group than that in PD-NRLS group .

    Table 1 Demographic variables of PD-RLS and PD-NRLS groups.

    Further analysis suggested that RLS-RS score was negatively correlated with the levels of DA and 5-HT in CSF .

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    The Link Between Rls And Parkinsons: Dopamine Agonists

    Although the cause of RLS remains unknown, we know that RLS runs in families in about one-half of the cases, and that some families have an abnormality on chromosome 12. Because RLS is well treated by medications that also treat Parkinsons disease, it is likely that some aspect of brain dopamine function is altered in RLS. However, unlike in Parkinsons disease, in which the deficit in substantia nigra dopamine-producing cells can be proven in many ways, no such abnormality has been shown in RLS. For example, studies show that there is no major deficit on PET or other imaging studies of the brain, as is there is in PD. The spinal fluid is normal in RLS, but shows low dopamine in PD.

    Lastly, RLS does not progress to cause other major symptoms such as tremor, gait disorder, or loss of taste or smell, and does not progress to PD. In fact, one of the leading possibilities as the cause of RLS and for which there is good scientific evidence and much research is a form of iron-transport abnormality in the brain. In effect, RLS patients may have low levels of iron in brain nerve cellsjust the opposite of some portions of the brain in PD.

    Dr. Poceta is a Consultant in Neurology and Sleep Disorders in the Division of Neurology, Scripps Clinic, La Jolla, and the Scripps Clinic Sleep Center. His current interests include organized medicine and Internet medicine.

    Yoga And Restless Legs Syndrome

    Restless Leg Syndrome in Parkinsonism with Dr. Abdul Rana MD

    Some new studies suggest that yoga might help ease symptoms of restless legs syndrome, but research is ongoing, so there isnt enough evidence yet to understand the full benefits. We do know that people with Parkinsons tell us that yoga is useful for managing their Parkinsons in general.

    Bhanu Ramaswamy, Physiotherapist explains in more detail below.

    We know from anecdotal stories, and from research evidence, that yoga can help lessen slowness and stiffness, improve balance and flexibility , and increase muscle strength and power. There are lots of different forms of yoga, and specific poses can work on different parts of the body.

    Some research has also shown the benefits of yoga in helping to reduce the symptoms of restless legs syndrome, especially if done with slow stretches combined with breathing techniques. So overall, yoga might be a great all-round activity for people with Parkinsons to ease a number of issues and improve day to day life.

    Watch our video to find out how yoga helps Janet manage her Parkinsons.

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    What Is The Link Between Restless Legs Syndrome And Periodic Limb Movement Disorder

    More than 80% of people with restless legs syndrome also have periodic limb movement disorder, or PLMD. In PLMD, the arms or legs twitch or jerk during the night. The movements disturb sleep and can cause chronic sleepiness.

    Many people have periodic limb movement disorder by itself and will never develop restless legs syndrome. If you think you have PLMD, see your doctor.

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    Home Care Tips For Restless Legs Syndrome

    The following approaches can reduce symptoms in patients with mild or moderate RLS and may be used in combination with medication in RLS patients who have severe symptoms.

    • Sleep hygiene: Good sleep hygiene means maintaining a bedroom environment and a daily routine that supports high-quality sleep. Avoiding alcohol and caffeine is especially important for RLS patients because these substances can worsen symptoms.
    • Exercise: Because physical inactivity often triggers RLS symptoms, exercise may be helpful. A research study found that RLS patients showed af 39% reduction in symptom severity after six weeks of engaging in an exercise program compared to an 8% symptom reduction in patients who did not exercise.
    • Pneumatic pressure therapy: Pneumatic compression devices increase blood flow to the legs by filling with air to squeeze the legs. Researchers found that the device improved RLS symptoms, quality-of-life, and fatigue after one month of daily use compared to a control group.
    • Massage and hot baths: Using massage and hot baths to stimulate the legs is widely recommended in RLS literature however, there is limited scientific evidence supporting the effectiveness of these methods at this time.

    Learn more about treating RLS here.

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