Therapeutic advances in restless legs syndrome (RLS)

Högl, Birgit; Comella, Cynthia L.

doi:10.1002/mds.26381

Cited by 10 publications

(3 citation statements)

References 47 publications

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“…Symptomatic drug treatment includes dopaminergic medication (levodopa, dopamine agonists), α2δ ligands (gabapentin, pregabalin), and opioids and GABA-A receptor agonists. See Table 5 [94][95][96][97][98][99]. In the few available direct comparative studies (pramipexole versus dual-release levodopa, or gabapentin versus ropinirole), similar effects on RLS were observed [100,101].…”

Section: Sleep-related Movement Disordersmentioning

confidence: 86%

Pharmacological Treatments of Sleep–Wake Disorders: Update 2023

Kallweit,

Kallweit

2023

CTN

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Biological, environmental, behavioral, and social factors can influence sleep and lead to sleep disorders or diseases. Sleep disorders are common, numerous, and heterogeneous in terms of their etiology, pathogenesis, and symptomatology. The management of sleep–wake circadian disorders (SWCDs) includes education on sleep hygiene, behavioral strategies, psychotherapy (cognitive behavioral therapy (CBT), particularly), instrument-based treatments (i.e., positive airway pressure therapy, hypoglossal nerve stimulation), and pharmacotherapy. Depending on the disease, therapy varies and is executed sequentially or can be a combination of several forms of therapy. Drugs used for SWCDs include traditional sleep- or wake-promoting agents and chronotherapeutic agents. Recently, novel medications, which more precisely act on specific neurochemical systems (i.e., the orexin system) important for sleep and waking, are also increasingly being used. In this review, the pharmacotherapy of common sleep disorders (insomnia, sleep-related breathing disorder, central disorders of hypersomnolence, circadian rhythm sleep–wake disorders, parasomnias, and sleep-related movement disorders) embedded in the overall therapeutic concept of each disorder is presented. There is also an outlook on possible future pharmacotherapies.

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Section: Sleep-related Movement Disordersmentioning

confidence: 86%

Pharmacological Treatments of Sleep–Wake Disorders: Update 2023

Kallweit,

Kallweit

2023

CTN

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“…Previous PET studies have revealed abnormalities in the dopaminergic system, such as hypofunction of the mesolimbic and nigrostriatal dopaminergic pathways [ 85 , 86 ]. Treatment with L-Dopa or dopamine agonists significantly reduced unpleasant sensations, pain, and sensory dysfunction in patients with restless legs syndrome [ 87 ]. These positive results of the use of dopaminergic drugs support the hypothesis that dopaminergic impairment can contribute to the development of symptoms of restless legs syndrome.…”

Section: Administration Of Dopaminergic Drugsmentioning

confidence: 99%

Association between Chronic Pain and Alterations in the Mesolimbic Dopaminergic System

et al. 2020

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Chronic pain (pain lasting for >3 months) decreases patient quality of life and even occupational abilities. It can be controlled by treatment, but often persists even after management. To properly control pain, its underlying mechanisms must be determined. This review outlines the role of the mesolimbic dopaminergic system in chronic pain. The mesolimbic system, a neural circuit, delivers dopamine from the ventral tegmental area to neural structures such as the nucleus accumbens, prefrontal cortex, anterior cingulate cortex, and amygdala. It controls executive, affective, and motivational functions. Chronic pain patients suffer from low dopamine production and delivery in this system. The volumes of structures constituting the mesolimbic system are known to be decreased in such patients. Studies on administration of dopaminergic drugs to control chronic pain, with a focus on increasing low dopamine levels in the mesolimbic system, show that it is effective in patients with Parkinson’s disease, restless legs syndrome, fibromyalgia, dry mouth syndrome, lumbar radicular pain, and chronic back pain. However, very few studies have confirmed these effects, and dopaminergic drugs are not commonly used to treat the various diseases causing chronic pain. Thus, further studies are required to determine the effectiveness of such treatment for chronic pain.

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“…Dopaminergic agonists are considered the gold standard treatment for RLS [5]. However, dopaminergic medications are associated with "augmentation," a phenomenon characterized by RLS symptoms that start earlier in the daytime, and ascend up the body, sometimes involving the arms and trunk [6]. Also, dopaminergic therapies are associated with impulse control disorders, such as punding, pathologic gambling, binge eating and hypersexuality [7].…”

Section: Introductionmentioning

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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Therapeutic advances in restless legs syndrome (RLS)

Cited by 10 publications

References 47 publications

Pharmacological Treatments of Sleep–Wake Disorders: Update 2023

Pharmacological Treatments of Sleep–Wake Disorders: Update 2023

Association between Chronic Pain and Alterations in the Mesolimbic Dopaminergic System

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

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