Idiopathic restless legs syndrome:

Schattschneider, Jörn; Bode, Andre; Wasner, Gunnar; Binder, Andreas; Deuschl, Günther; Baron, Ralf

doi:10.1007/s00415-004-0475-3

Cited by 70 publications

(10 citation statements)

References 27 publications

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“…The study’s authors noted that RLS should perhaps be categorized as a disorder of central pain processing as well as a motor and sleep disorder (16), a suggestion echoed by other RLS researchers (3;10;17). In addition, one functional neuroimaging study revealed a dysfunctional pattern of cerebral endogenous opioid binding in RLS patients.…”

Section: Introductionmentioning

confidence: 94%

Alterations in pain responses in treated and untreated patients with restless legs syndrome: Associations with sleep disruption

et al. 2011

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Objective There has been recent interest in characterizing potential abnormalities of pain processing in patients with sleep disorders such as Restless Legs Syndrome (RLS). The aim of this study was to evaluate psychophysical responses to noxious heat and pressure stimuli in both treated and untreated RLS patients, compared to matched controls. Methods This study is a cross-sectional group comparison of RLS patients with matched controls. A total of 31 patients (15 treated, 16 untreated) with a confirmed diagnosis of RLS were compared to 18 controls with no history of RLS or related sleep disorders. Results RLS patients (both treated and untreated) demonstrated reduced pain thresholds and reported greater clinical pain relative to controls. Moreover, RLS patients demonstrated enhanced temporal summation of heat pain (p< .05), which may reflect aberrant central nervous system facilitation of pain transmission. Both treated and untreated RLS patients reported disrupted sleep relative to controls, and mediation analyses suggested that the reduced pain thresholds in RLS were attributable to sleep disturbance. However, the effect of RLS on the magnitude of temporal summation of heat pain was independent of sleep disturbance. Conclusions These findings suggest that central nervous system pain processing may be amplified in RLS, perhaps partially as a consequence of sleep disruption. RLS patients, even those whose symptoms are managed pharmacologically, may be at elevated long-term risk for the development or maintenance of persistent pain conditions. Further studies in larger samples could help to improve the prospects for pain management in RLS patients.

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Section: Introductionmentioning

confidence: 94%

Alterations in pain responses in treated and untreated patients with restless legs syndrome: Associations with sleep disruption

et al. 2011

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“…Moreover, it remains debated to what degree RLS is a central versus peripheral nervous system disorder. In primary RLS, nerve conduction studies show normal values, however studies have suggested that RLS patients may have abnormal temperature perception, possibly due to small fiber neuropathy [23] or impairment in central somatosensory processing [24]. The argument against a purely peripheral etiology for RLS includes the fact that patients with amputations have developed RLS symptoms responsive to dopamine agonists [25] [26].…”

Section: Discussionmentioning

confidence: 99%

Randomized pilot trial for the efficacy of the MMF07 foot massager and heat therapy for restless legs syndrome

2020

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Background Restless Legs Syndrome (RLS) is a sensorimotor condition with a wide range of severity. Symptoms negatively affect sleep and quality of life. Pharmacologic options are not universally effective and side effects are common. Objective data regarding non-pharmacologic treatment is limited. The study objective was to evaluate the efficacy of the MMF07 foot massager and heat therapy on the severity of RLS symptoms. Methods In this pilot randomized controlled trial, twenty-eight patients with diagnosed, bothersome RLS were randomized to four treatment arms: no active intervention (n = 7), foot massager (n = 8), heat therapy (n = 6), and foot massager plus heat therapy (n = 7). Participants completed the RLS Severity Scale, RLS Quality of Life questionnaire, and the Medical Outcomes Study Sleep scale at the baseline visit and at the 4-week follow up visit. Results Four weeks post randomization, participants in the massager group had significant improvement in the RLS severity score (average difference:-9.0, 95% CI:-16.3,-1.7, p = 0.017) and sleep scale (average difference:-22.0, 95% CI:-36.5,-7.5, p = 0.005) compared to the no intervention group. The heat alone group had a significant improvement in the sleep scale compared to the no-intervention group (average difference:-17.4, 95% CI:-32.5,-2.3, p = 0.026). Quality of life improved in the massage only group compared to control (average difference 25.3, 95% CI:-2.4, 53.0, p = 0.072). Conclusions Results suggest that the MMF07 foot massage device and heat therapy may be feasible and effective treatment options to improve RSL symptoms.

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“…The authors attribute these differences to abnormal central somatosensory processing among patients with primary RLS while these are attributed to small fiber neuropathy in patients with secondary RLS. [7] In a recent study, 21 patients with primary RLS were compared with 13 patients with secondary RLS (with co-existent small fiber neuropathy confirmed by skin biopsy) and 20 normal controls, the patients with primary RLS showed hyperalgesia to blunt pressure, pinprick, and vibratory hyperesthesia while patients with secondary RLS, associated with small fiber neuropathy, showed thermal hypoesthesia to cold (A delta-fiber mediated) and warm (C-fiber mediated) and hyperalgesia to pinprick. [8] These authors conclude that static mechanical hyperalgesia in primary and secondary restless legs syndrome is consistent with the concept of central disinhibition of nociceptive pathways, which might be induced by conditioning afferent input from damaged small fiber neurons in secondary restless legs syndrome.…”

Section: Discussionmentioning

confidence: 99%

Quantitative thermal sensory testing and sympathetic skin response in primary Restless legs syndrome - A prospective study on 57 Indian patients

Shukla

Goyal

Srivastava

et al. 2012

Ann Indian Acad Neurol

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Patients with restless leg syndrome present with sensory symptoms similar to peripheral neuropathy. While there is evidence of abnormalities of dopaminergic pathways, the peripheral nervous system has been studied infrequently. We studied conventional nerve conduction studies, quantitative thermal sensory testing and sympathetic skin response in 57 patients with primary restless leg syndrome. Almost two third patients demonstrated abnormalities in the detailed testing of the peripheral nervous system. Sbtle abnormalities of the peripheral nervous system may be more common than previously believed.

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Idiopathic restless legs syndrome:

Abstract: Impairment of temperature perception is present in a high percentage of RLS patients. In secondary RLS the sensory deficits are at least in part caused by small fibre neuropathy. In idiopathic RLS a functional impairment of central somatosensory processing is present.

Cited by 70 publications

References 27 publications

Alterations in pain responses in treated and untreated patients with restless legs syndrome: Associations with sleep disruption

Alterations in pain responses in treated and untreated patients with restless legs syndrome: Associations with sleep disruption

Randomized pilot trial for the efficacy of the MMF07 foot massager and heat therapy for restless legs syndrome

Quantitative thermal sensory testing and sympathetic skin response in primary Restless legs syndrome - A prospective study on 57 Indian patients

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