Restless Legs Syndrome in Alzheimer’s and Parkinson’s Disease

Restless legs syndrome (RLS) is a neurological disorder characterized by the urge to move the legs associated with peculiar unpleasant sensations during periods of rest and inactivity that are relieved by movement. A few studies analyzed RLS in neurodegenerative diseases such as Alzheimer’s Disease (AD).

Check out David Wimble’s site http://www.rlcure.com/ for more info on RLS.

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

It concluded that RLS prevalence in AD cohort was estimated to be about 4%. RLS appeared to be associated with neuropsychiatric symptoms such as apathy. RLS and apathy might share a common pathophysiological basis represented by a dysfunction of the central dopaminergic system.

Methods: Three hundred and thirty-nine subjects with a diagnosis of AD were recruited. Cognitive, functional, and neuropsychiatric measures were collected at baseline and six-monthly for a 2-years follow-up

Results: Fourteen subjects met the RLS criteria. RLS subjects were more frequently male (p:0,006) and younger than AD subject without RLS (p:0,029). MMSE, ADL and IADL were not significantly different. NPI total scores did not differ significantly, however, AD patients with RLS were found to be more apathetic (p:0,001) than AD subjects without RLS.
TALARICO, G., CANEVELLI, M., TOSTO, G., VANACORE, N., LETTERI, F., PRASTARO, M., TROILI, F., GASPARINI, M., LENZI, G. L., BRUNO, G. AMERICAN JOURNAL OF ALZHEIMER’S DISEASE AND OTHER DEMENTIAS28(2):165-170, 20131533-3175

Restless legs syndrome (RLS) and Parkinson’s disease (PD)

Restless legs syndrome (RLS) and Parkinson’s disease (PD) are both common neurological disorders. There has been much debate over whether an etiological link between these two diseases exists and whether they share a common pathophysiology. Evidence pointing towards a link includes response to dopaminergic agents in PD and RLS, suggestive of underlying dopamine dysfunction in both conditions.
The extrastriatal dopaminergic system, in particular altered spinal dopaminergic modulation, may be variably involved in PD patients with RLS symptoms. In addition, there is now evidence that the nigrostriatal system, primarily involved in PD, is also affected in RLS.

Furthermore, an association of RLS with the parkin mutation has been suggested. The prevalence of RLS has also been reported to be increased in other disorders of dopamine regulation. However, clinical association studies and functional imaging have produced mixed findings. Conflicting accounts of emergence of RLS and improvement in RLS symptoms after deep brain stimulation (DBS) also contribute to the uncertainty surrounding the issue. Among the strongest arguments against a common pathophysiology is the role of iron in RLS and PD.

While elevated iron levels in the substantia nigra contribute to oxidative stress in PD, RLS is a disorder of relative iron deficiency, with symptoms responding to replacement therapy. Recent ultrasonography studies have suggested that, despite overlapping clinical features, the mechanisms underlying idiopathic RLS and RLS associated with PD may differ. In this review, we provide a concise summary of the clinical, imaging and genetic evidence exploring the link between RLS and PD.

Tasneem Peeraully and Eng-King Tan. Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore

Keywords:
Parkinson’s disease; Restless-legs syndrome; Pathophysiology; Dopaminergic dysfunction.

Connie’s comments: Eat whole foods, lessen iron supplementation, take calcium and magnesium with Vit D and C supplements and avoid metal toxicities.

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Connie’s Comments

Nutrition is the key and regular walking with sunshine. Massage legs with ginger and coconut oil or use the same for foot bath and add EPSOM salts.

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