Post-stroke restless leg syndrome and periodic limb movements in sleep

Woo, Ho Geol; Lee, D.; Hwang, Kyoung Jin; Ahn, Tae-Beom

doi:10.1111/ane.12582

Cited by 40 publications

(35 citation statements)

References 23 publications

(37 reference statements)

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“…As the whole-brain results of our study show, the most important and interhemispheric variations occur in the basal ganglia, with the medial and lateral striata contributing the most to the clinical and anamnestic differences in the pregnancy-related RLS group. Along with our results, the human lesion studies (Lee et al, 2009; Shiina et al, 2019; Woo et al, 2017) as well as the recent RLS animal model studies (Guo et al, 2017) underscore the crucial role of the basal ganglia in the manifestation of the RLS spectrum. Based on the brain phenotype model, we conclude therefore that different factors such as stress response, history of SLE or life circumstances (e.g.…”

Section: Discussionsupporting

confidence: 84%

Phenotypical predictors of Restless Legs Syndrome in pregnancy and their association with basal ganglia and the limbic circuits

Chechko

Lefort-Besnard

Goecke

et al. 2020

Preprint

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The pregnancy-related restless legs syndrome (RLS) is thought to have a multifactorial etiology. However, the reason behind the manifestation of RLS during pregnancy remains largely elusive. A neurological and obstetrical cohort of 308 postpartum women was screened for RLS symptoms twice: 1 to 6 days (T0) and 12 weeks postpartum (T1). 57 participants were identified as affected by pregnancy-associated RLS. The clinical and anamnestic indicators of the condition were assessed by a pattern-learning classifier trained to predict the RLS status. Structural MRI was obtained from 25 of the 57 participants with RLS history in pregnancy. In this sample, a multivariate two-window algorithm was employed to systematically chart the relationship between brain structures and phenotypical predictors. The RLS prevalence rate in our sample was 19% (n=57), with the women suffering from RLS being older, more often unmarried, affected by gestational diabetes and having been more exposed to stressful life events. A history of RLS and the severity and frequency of repetitive compulsive movements were found to be the strongest predictors of RLS manifestation. In the RLS group, high cortisol levels, being married and receiving iron supplements were found to be associated with increased volumes in the bilateral striatum. Investigating pregnancy-related RLS in a frame of brain phenotype modes may help shed light on the heterogeneity of the condition.

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Section: Discussionsupporting

confidence: 84%

Phenotypical predictors of Restless Legs Syndrome in pregnancy and their association with basal ganglia and the limbic circuits

Chechko

Lefort-Besnard

Goecke

et al. 2020

Preprint

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“…Iron deficiency is also strongly associated with RLS and so it is of interest that low levels of iron have been detected in the BG and RN 30 – 33 . Moreover, strokes occurring within the BG, internal capsule, pons and cerebellum are strongly associated with the development of RLS 34 , 35 . Finally, transcranial magnetic stimulation (TMS) over motor cortex reduces RLS 36 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Targeted disruption of supraspinal motor circuitry reveals a distributed network underlying Restless Legs Syndrome (RLS)-like movements in the rat

Guo

Yang

Zhan

et al. 2017

Sci Rep

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In this study we uncovered, through targeted ablation, a potential role for corticospinal, cerebello-rubro-spinal, and hypothalamic A11 dopaminergic systems in the development of restless legs syndrome (RLS)-like movements during sleep. Targeted lesions in select basal ganglia (BG) structures also revealed a major role for nigrostriatal dopamine, the striatum, and the external globus pallidus (GPe) in regulating RLS-like movements, in particular pallidocortical projections from the GPe to the motor cortex. We further showed that pramipexiole, a dopamine agonist used to treat human RLS, reduced RLS-like movements. Taken together, our data show that BG-cortico-spinal, cerebello-rubro-spinal and A11 descending projections all contribute to the suppression of motor activity during sleep and sleep-wake transitions, and that disruption of these circuit nodes produces RLS-like movements. Taken together with findings from recent genomic studies in humans, our findings provide additional support for the concept that the anatomic and genetic etiological bases of RLS are diverse.

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“…In general, dopamine agonists, though associated with more side effects, played more effective roles than levodopa, since significant relief was reported in most patients taking dopamine agonists. In addition, the rate of spontaneous improvement observed was approximately 25%, indicating that some patients can go without pharmacotherapy [21,112]. Iron supplementation is an important step of treatment in patients with iron deficiency.…”

Section: Treatments Of Rbd and Rls In Strokementioning

confidence: 99%

Sleep Disorders in Stroke: An Update on Management

2021

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Stroke is a leading cause of disability and mortality all over the world. Due to an aging population, the incidence of stroke is rising significantly, which has led to devastating consequences for patients. In addition to traditional risk factors such as age, hypertension, hyperlipidemia, diabetes and atrial fibrillation, sleep disorders, as independent modifiable risk factors for stroke, have been highlighted increasingly. In this review, we provide an overview of common types of current sleep disturbances in cerebrovascular diseases, including insomnia, hypersomnia, breathing-related sleep disorders, and parasomnias. Moreover, evidence-based clinical therapeutic strategies and pitfalls of specific sleep disorders after stroke are discussed. We also review the neurobiological mechanisms of these treatments as well as their effects on stroke. Since depression after stroke is so prevalent and closely related to sleep disorders, treatments of post-stroke depression are also briefly mentioned in this review article.

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Post-stroke restless leg syndrome and periodic limb movements in sleep

Abstract: The observed differences in the clinical and radiological features of psRLS and psPLMS suggest that the pathophysiologies of the two conditions are distinct. Further research is needed to understand the pathophysiologies of primary RLS and PLMS.

Cited by 40 publications

References 23 publications

Phenotypical predictors of Restless Legs Syndrome in pregnancy and their association with basal ganglia and the limbic circuits

Phenotypical predictors of Restless Legs Syndrome in pregnancy and their association with basal ganglia and the limbic circuits

Targeted disruption of supraspinal motor circuitry reveals a distributed network underlying Restless Legs Syndrome (RLS)-like movements in the rat

Sleep Disorders in Stroke: An Update on Management

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