Randomized, placebo-controlled trial of ferric carboxymaltose in restless legs syndrome patients with iron deficiency anemia

Bae, Hyoeun; Cho, Yong Won; Kim, Keun Tae; Allen, Richard P.; Earley, Christopher J.

doi:10.1016/j.sleep.2021.05.036

Cited by 12 publications

(6 citation statements)

References 35 publications

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“…Either oral or intravenous iron has been shown to be effective in double-blind studies for the treatment or RLS. 55 , 56 In this context it is important to note that, although iron is a mainstay for the treatment of iron deficiency anaemia, iron therapy in combination with erythropoiesis-stimulating agents has improved anaemia in some cases of inflammatory anaemia. 32 , 33 Chronic inflammation can lead to high hepcidin production, which inhibits intestinal absorption of iron.…”

Section: Discussionmentioning

confidence: 99%

Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome

Walters,

Li,

Koo

et al. 2023

Brain

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Restless legs syndrome (RLS) is responsive to opioid, dopaminergic, and iron-based treatments. Receptor blocker studies in RLS patients suggest that the therapeutic efficacy of opioids is specific to the opioid receptor and mediated indirectly through the dopaminergic system. An RLS autopsy study reveals decreases in endogenous opioids, β-endorphin, and perhaps metenkephalin in the thalamus of RLS patients. A total opioid receptor knock-out (mu, delta, and kappa) and a mu-opioid receptor knock-out mouse model of RLS show circadian motor changes akin to RLS, and, although both models show sensory changes, the mu-opioid receptor knock mouse shows circadian sensory changes closest to those seen in idiopathic RLS. Both models show changes in striatal dopamine, anemia, and low serum iron. However, only in the total receptor knock-out mouse do we see the decreases in serum ferritin that are normally found in RLS. There are also decreases in serum iron when wild-type mice are administered a mu-opioid receptor blocker. In addition, the mu-opioid receptor knock-out mouse also shows increases in striatal zinc paralleling similar changes in RLS. Adrenocorticotropic Hormone (ACTH) and α-Melanocyte Stimulating Hormone (α-MSH) are derived from Pro-opiomelanocortin (POMC) as is β-endorphin. However, they cause RLS-like symptoms and Periodic Limb Movements (PLMS) when injected intraventricularly into rats. These results collectively suggest that an endogenous opioid deficiency is pathogenetic to RLS and that an altered melanocortin system may be causal to RLS as well.

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Section: Discussionmentioning

confidence: 99%

Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome

Walters,

Li,

Koo

et al. 2023

Brain

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“…Additionally, MRI measurements indicating enhanced brain iron content could serve as a promising biomarker for RLS patients. (Bae, 2021) In our study, it was observed that approximately 54.9% of individuals with restless legs syndrome (RLS) had a history of sleep problems, indicating a notable association between RLS and sleep-related issues. Two population surveys conducted in Sweden have investigated the prevalence of RLS and its impact on sleep.…”

Section: Discussionmentioning

confidence: 75%

Prevalence and Associated Factors of Restless Leg Syndrome

Khan,

Robab,

Ahmed

et al. 2024

jmhs

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To assess the prevalence and factors associated with restless leg syndrome among the students at Gulf Medical University. A cross-sectional study was conducted in Gulf Medical University (GMU), Ajman, UAE, upon approval from the Ethics Committee. A self-administered questionnaire was given to gather information from 624 students about Restless Legs Syndrome (RLS), covering things like age, gender, and factors associated with it. Among the students (164 boys and 452 girls), we found that 6.2% had restless leg syndrome. The results of the study showed a connection between restless leg syndrome and factors such as magnesium deficiency, vitamin B12 deficiency, anemia, and sleep disturbance. We did not find a significant link between age and restless leg syndrome in our study, as we focused on people aged 18 and older. In conclusion, we identified the most common factors connected to restless leg syndrome, including low magnesium, low vitamin B12, anemia, and sleep problems. These findings highlight that restless leg syndrome is complex and can affect young adults, with certain nutritional and lifestyle factors playing a role in its occurrence.

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“…In RLS, oral and intravenous iron supplementation are a mainstay of treatment. Both peripheral and central iron deficiency are implicated in RLS via serum, CSF, postmortem, and neuroimaging studies [ 75 93 105 106 ].…”

Section: Resultsmentioning

confidence: 99%

Vitamin D and Restless Legs Syndrome: A Review of Current Literature

Cederberg¹,

Silvestri²,

Walters³

2023

Tremor and Other Hyperkinetic Movements

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This review presents a detailed summary of the current literature regarding RLS and vitamin D deficiency. To our knowledge it is the first review of its kind. We review the prevalence of vitamin D deficiency in RLS as well as the evidence for the use of vitamin D supplementation in RLS management. We further examine the literature for proteomic and genetic evidence of a role for vitamin D in the pathogenesis of RLS. An alteration in vitamin D binding protein in RLS is one of the most consistent findings in the proteomic studies. Furthermore, we examine the interaction of vitamin D with calcium, phosphorus, and parathyroid hormone and the possible role of these connections in RLS. We also explore the possible nexus between RLS and vitamin D in renal disease, cardiovascular and cerebrovascular disease as well as inflammation. In addition, we review the potential interaction between vitamin D and RLS with iron, dopamine and other neurotransmitter systems including the endogenous opiate, serotoninergic, glutamatergic and adenosinergic systems. We also explore the role of vitamin D in RLS Augmentation (i.e., the paradoxical worsening of RLS symptoms when dopaminergic agents are used as a therapy for RLS). Although the literature is not entirely consistent in affirming vitamin D deficiency in RLS or the amelioration of RLS symptoms with vitamin D therapy, the collective studies overall indicate that vitamin D deficiency is common enough in RLS patients to suggest that RLS patients should have their vitamin D levels checked and any deficiency corrected as a standard of care. HighlightsPatients with Restless Legs Syndrome (RLS) may be deficient in vitamin D and therapy with vitamin D may ameliorate RLS. We present the first review dedicated solely to evaluating the relationship between RLS and vitamin D and present a case for the role of vitamin D in RLS pathogenesis.

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Randomized, placebo-controlled trial of ferric carboxymaltose in restless legs syndrome patients with iron deficiency anemia

Cited by 12 publications

References 35 publications

Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome

Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome

Prevalence and Associated Factors of Restless Leg Syndrome

Vitamin D and Restless Legs Syndrome: A Review of Current Literature

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