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Osteoarthritis Increases Paresthestic and Akathisic Pain, Anxiety Case-ness, and Depression Severity in Patients With Parkinson's Disease

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FRONTIERS IN NEUROLOGY 2018年第JUN期9卷 409-409页

作者： Rana, Abdul Qayyum Qureshi, Abdul Rehman Akhter, Shakib Ingar, Yameen Ayub, Ali Abdullah, Ismael Madhosh, Obaidullah Sarfraz, Zainab Rana, Muhammad B. Rana, Ruqqiyah Parkinsons Clin Eastern Toronto Clin Neurol Toronto ON 8 Canada Movement Disorders Ctr Toronto ON Canada

Objective: Parkinson's disease (PD) patients are known to suffer from pain, anxiety, and depression, but the exact degree of association between the two is unknown. As many PD patients also suffer from physical impairments, this cross-sectional case-control study sets out to compare and determine the case-ness of pain, anxiety and depression in PD patients that suffer with or without symptomatic osteoarthritis (OA). The goal of this study, therefore, was to observe if additional pain associated with comorbid OA in PD patients is correlated with greater depression and anxiety rates. The importance of understanding the burden of pain and increased depression severity of PD and OA patients is so that they may be screened appropriately based on the symptoms, which may increase their overall quality of life. Methods: This cross-sectional case-control study included 3 groups of 34 patients and 78 healthy age and gender-matched control participants. PD patients with symptomatic OA (PD+OA), PD patients without symptomatic OA (PD), patients with symptomatic OA but no PD (OA), and healthy control participants (Control). A PD patient group with restless legs syndrome (PD+RLS) of 27 patients was also included. All participants completed questionnaires to assess for pain, depression, and anxiety. Results: PD+OA and PD patients had worsened depression severity and were more likely to report anxiety and depression case-ness than OA patients. PD+OA patients were more likely to complain about paresthestic and akasthisic pain, but less likely to complain about aching pain compared to PD patients and OA patients. PD+OA patients were more likely to have greater pain severity, and were more likely to report radiating and sharp pain than PD+RLS patients. PDH-OA patients were also more likely to report higher depression case-ness than PD+RLS patients. Conclusion: PD with OA seems to be linked with specific pain characteristics (akathisia and paraesthesia) as well as heightened overall pai

关键词： Parkinson's disease osteoarthritis pain depression quality of life anxiety restless legs syndrome

来源： SCIE MEDLINE期刊

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Unfolding the role of exercise in the management of sleep disorders

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EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY 2024年第9期124卷 2547-2560页

作者： Giannaki, Christoforos D. Sakkas, Giorgos K. Hadjigeorgiou, Georgios M. Manconi, Mauro Bargiotas, Panagiotis Univ Nicosia Sch Life & Hlth Sci Dept Life Sci 46 Makedonitisas Ave CY-1700 Nicosia Cyprus Univ Thessaly Sch Phys Educ Sport Sci & Dietet Trikala Greece Univ Cyprus Med Sch Dept Neurol Nicosia Cyprus Reg Hosp Lugano Sleep Med Unit Neuroctr Southern Switzerland Lugano Switzerland Univ Cyprus Med Sch Sleep & Mot Lab Nicosia Cyprus

Sleep disorders are prevalent among the general population and even more in individuals suffering from chronic diseases. Recent data reveal promising effects of physical exercise as a non-pharmacological approach for improving sleep and managing various sleep disorders. However, more studies with proper design and methodology should be conducted in the future to obtain a clearer understanding of the subject. The role of exercise in preventing and improving sleep disorders is probably much higher than what is currently exploited. To fully exploit the potential benefit of physical activity on sleep disorders in the future, it is necessary to identify the relevant tools to assess sleep-wake disorders and establish specific exercise protocols tailored to different sleep disorders. The present manuscript aims to review the literature on the use of exercise in managing selected sleep disorders. Regular exercise, including short-term aerobic activity, resistance training, and mind-body exercises, can effectively improve sleep quality, particularly in cases of insomnia and sleep-disordered breathing. Additionally, increasing evidence supports the effectiveness of aerobic and strength training, and body-mind exercises such as yoga in managing sleep-related movement disorders. Exercise can be a safe, affordable, and efficient tool in enhancing sleep quality and improving sleep disorders. Per se, regular exercise could play an adjuvant role alongside with established therapies, or a valid alternative when the pharmacological approach is limited by side effects, interactions, or inefficacy. More research is needed to define how exercise affects the physiology of sleep, and consequently how to use exercise in patients with sleep disorders.

关键词： Aerobic exercise Insomnia Resistance exercise restless legs syndrome Sleep apnea

来源： SCIE

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Uremic Encephalopathy and Other Brain Disorders Associated with Renal Failure

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SEMINARS IN NEUROLOGY 2011年第2期31卷 139-143页

作者： Seifter, Julian Lawrence Samuels, Martin A. Harvard Univ Sch Med Brigham & Womens Hosp Dept Neurol Boston MA 02115 USA Harvard Univ Sch Med Brigham & Womens Hosp Dept Nephrol Boston MA 02115 USA

Kidney failure is one of the leading causes of disability and death and one of the most disabling features of kidney failure and dialysis is encephalopathy. This is probably caused by the accumulation of uremic toxins. Other important causes are related to the underlying disorders that cause kidney failure, particularly hypertension. The clinical manifestations of uremic encephalopathy include mild confusional states to deep coma, often with associated movement disorders, such as asterixis. Most nephrologists consider cognitive impairment to be a major indication for the initiation of renal replacement therapy with dialysis with or without subsequent transplantation. Sleep disorders, including Ekbom's syndrome (restless legs syndrome) are also common in patients with kidney failure. Renal replacement therapies are also associated with particular neurologic complications including acute dialysis encephalopathy and chronic dialysis encephalopathy, formerly known as dialysis dementia. The treatments and prevention of each are discussed.

关键词： Uremic encephalopathy uremia restless legs syndrome dialysis dementia dialysis encephalopathy

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Daytime symptoms in restless legs syndrome - An underestimated problem?

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SLEEP MEDICINE 2012年第2期13卷 121-122页

作者： Baier, Paul Christian Univ Kiel Dept Psychiat & Psychotherapy Ctr Sleep Med D-24105 Kiel Germany

restless legs syndrome (RLS) is typically characterized by unpleasant sensations in the limbs, often the lower limbs, and associated with an urge to move them. Since the historic description by Ekbom in the 1940s it has been widely assumed that these paraesthesias are \"...mostly felt during the night...\" and \"...are either entirely absent or are of a mild degree...\" during the daytime [1]. Ekbom\'s observation was later confirmed by a few studies that systematically investigated RLS symptoms during the course of the day and found that the severity of subjective leg discomfort measured with (modified) suggested immobilization tests in untreated patients increases during the late evening and peaks in the middle of the night, with a minimum of symptoms in the morning [2-4]. Although Ekbom already found that daytime symptoms occur, the obvious and frequent problem of patients\' difficulties falling and staying asleep identified restless-legs-syndrome as a sleep disorder. This might explain why previous questionnaire surveys reported an impact on daytime functioning in around 50% of patients [5,6], but did not differentiate if this resulted from daytime symptoms or from impaired sleep. Furthermore, a previous epide-miological study reported that 10% of the patients had daytime symptoms, but defined daytime only as before 6 p.m. [7].

关键词： restless legs syndrome Symptoms night Daytime Paresthesia Sleep Disorders

来源： ClinicalKey（临床精钥... SCIE

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Clinical difficulties in the treatment of restless legs syndrome: it is the dose that makes poison

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EUROPEAN PSYCHIATRY 2022年第S1期65卷 S723-S724页

作者： Petrykiv, S. Arts, M. Jonge, L. GGZWNB Psychiat Halsteren Netherlands GGZWNB Psychiat Bergen Op Zoom Netherlands

EPV1182

关键词： Ropinirole Depression Side effects restless legs syndrome

来源： SCIE PubMed Central

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restless legs syndrome: A clinical study of 55 patients

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EUROPEAN NEUROLOGY 2001年第2期45卷 67-74页

作者： Bassetti, CL Mauerhofer, D Gugger, M Mathis, J Hess, CW Univ Hosp Bern Inselspital Dept Neurol CH-3010 Bern Switzerland Univ Hosp Bern Inselspital Div Pneumol CH-3010 Bern Switzerland

Background: restless legs syndrome (RLS) is a common sleep disorder. In 1995, clinical criteria for the diagnosis of RLS were defined. Objective: To describe the clinical spectrum in a series of unselected RLS patients meeting the new diagnostic criteria. Methods: We prospectively assessed by questionnaire and clinical assessment the characteristics of 55 consecutive RLS patients (35 women, 20 men;mean age = 62 +/- 16 years). Results: In 27% of the patients, RLS started before the age of 20 years (early-onset RLS), Sensory disturbances were painful in 56% of patients and felt in legs (98%), arms (35%), and 'internally' (45%). Motor disturbances included 'dyskinesias while awake' (36%), Insomnia (58%) was commoner than hypersomnia (24%). In 67% of the patients, no etiology of RLS was found (idiopathic RLS), Early-onset RLS was more commonly familial (p = 0.01) and associated with 'growing pains' (p = 0.005) than late-onset RLS. Patients with RLS and hypersomnia were younger (p = 0.01) and less commonly had painful sensations (p = 0.04) than patients with RLS and insomnia. Patients with idiopathic RLS were younger (p = 0.004), and less commonly had insomnia (p = 0.01) than patients with symptomatic RLS. Conclusions: RLS is a clinically pleomorphic syndrome, reflecting the contribution of multiple genetic and acquired factors in the pathogenesis of RLS, Copyright (C) 2001 S. Karger AG, Basel.

关键词： restless legs syndrome insomnia hypersomnia Epworth sleepiness scale

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restless legs syndrome in migraine patients: prevalence and severity

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EUROPEAN JOURNAL OF NEUROLOGY 2016年第6期23卷 1110-1116页

作者： van Oosterhout, W. P. J. van Someren, E. J. W. Louter, M. A. Schoonman, G. G. Lammers, G. J. Rijsman, R. M. Ferrari, M. D. Terwindt, G. M. Leiden Univ Med Ctr Dept Neurol K5-Q-93PO 9600 NL-2300 WB Leiden Netherlands Netherlands Inst Neurosci Amsterdam Netherlands VU Univ & Med Ctr CNCR Dept Integrat Neurophysiol Neurosci Campus Amsterdam Amsterdam Netherlands VU Univ & Med Ctr CNCR Dept Med Psychol Neurosci Campus Amsterdam Amsterdam Netherlands Leiden Univ Med Ctr Dept Neurol Leiden Netherlands Leiden Univ Med Ctr Dept Psychiat Leiden Netherlands Elisabeth Tweesteden Hosp Tilburg Dept Neurol Tilburg Netherlands Sleep Wake Ctr SEIN Heemstede Heemstede Netherlands Med Ctr Haaglanden Ctr Sleep & Wake Disorders The Hague Netherlands

Background and purpose: Our aim was to study not only the prevalence but more importantly the severity and the correlation between sleep quality and restless legs syndrome (RLS) in a large population of well-defined migraine patients as poor sleep presumably triggers migraine attacks. Methods: In a large cross-sectional and observational study, data on migraine and RLS were collected from 2385 migraine patients (according to the International Classification of Headache Disorders ICHD-IIIb) and 332 non-headache controls. RLS severity (International RLS Study Group severity scale) and sleep quality (Pittsburgh Sleep Quality Index) were assessed. Risk factors for RLS and RLS severity were calculated using multivariable-adjusted regression models. Results: restless legs syndrome prevalence in migraine was higher than in controls (16.9% vs. 8.7%;multivariable-adjusted odds ratio 1.83;95% confidence interval 1.18-2.86;P = 0.008) and more severe (adjusted severity score 14.5 +/- 0.5 vs. 12.0 +/- 1.1;P = 0.036). Poor sleepers were overrepresented amongst migraineurs (50.1% vs. 25.6%;P restless legs syndrome is not only twice as prevalent but also more severe in migraine patients, and associated with decreased sleep quality.

关键词： clinical profile LUMINA migraine restless legs syndrome

来源： ebsco(ASP/aph)

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Therapy of fatigue in multiple sclerosis. A treatment algorithm

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NERVENARZT 2016年第12期87卷 1310-1321页

作者： Veauthier, C. Paul, F. Charite Interdisziplinares Schlafmed Zentrum Charitepl 1 D-10117 Berlin Germany Charite NeuroCure Clin Res Ctr Neurol Klin Berlin Germany Charite Klin & Expt Forschungszentrum Multiple Sklerose Neurol Klin Berlin Germany ECRC Berlin Germany

Fatigue is one of the most frequent symptoms of multiple sclerosis (MS) and one of the main reasons for underemployment and early retirement. The mechanisms of MS-related fatigue are unknown but comorbid disorders play a major role. Anemia, diabetes, side effects of medication and depression should be ruled out. Moreover, excessive daytime sleepiness (EDS) should be differentiated from fatigue. No approved medicinal therapy of MS fatigue is currently available. Presentation of current treatment strategies with a particular focus on secondary fatigue due to sleep disorders. A review of the literature was carried out. All MS patients suffering from fatigue should be questioned with respect to EDS and if necessary sleep medical investigations should be carried out;however, pure fatigue without accompanying EDS can also be caused by a sleep disorder. Medications, particularly freely available antihistamines, can also increase fatigue. Furthermore, anemia, iron deficits, diabetes and hypothyroidism should be excluded. Self-assessment questionnaires show an overlap between depression and fatigue. Several studies have shown that cognitive behavioral therapy and various psychotherapeutic measures, such as vertigo training, progressive exercise training and individualized physiotherapy as well as fatigue management interventions can lead to a significant improvement of MS-related fatigue. There is currently no medication which is suitable for treatment of fatigue, with the exception of fampridine for the treatment of motor functions and motor fatigue.

关键词： Sleep disorders Polysomnography Insomnia restless legs syndrome Sleep medicine

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restless legs symptoms in thyroid disorders

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PARKINSONISM & RELATED DISORDERS 2004年第3期10卷 149-151页

作者： Tan, EK Ho, SC Eng, P Loh, LM Koh, L Lum, SY Teoh, ML Yih, Y Khoo, D Singapore Gen Hosp Dept Neurol Div Med Singapore 169608 Singapore Singapore Gen Hosp Natl Inst Neurosci Singapore 169608 Singapore

Dopaminergic dysfunction is associated with thyroid disorders and restless legs syndrome (RLS). In a 'face-to-face' interview, we evaluated for RLS using the diagnostic criteria of the International restless legs syndrome Study Group (IRLSSG) in patients diagnosed biochemically with either hyper- or hypothyroidism, and in controls without thyroid disorders. Amongst 146 consecutive patients with biochemically confirmed thyroid disorders, none satisfied all the IRLSSG criteria of RLS, similar to the control population (0.2%, 1/434). However, we found 8.2% (12/146) with RLS-like symptoms (satisfied the first 3 IRLSSG criteria) compared to 0.9% (4/434) in the controls (p < 0.0001). Four (33.3%) of these patients reported complete resolution of these symptoms after treatment for their thyroid condition. In conclusion, while RLS-like symptoms were observed in some patients with thyroid disorders, our study demonstrates no significant difference of RLS prevalence between patients with thyroid disorders and euthyroid controls. (C) 2004 Elsevier Ltd. All rights reserved.

关键词： restless legs syndrome hyperthyroidism hypothyroidism

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Sleep disorders in Wilson's disease

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SLEEP MEDICINE 2021年 83卷 299-303页

作者： De Cock, Valerie Cochen Lacombe, Sandy Woimant, France Poujois, Aurelia Beau Soleil Clin Sleep & Neurol Unit Montpellier France Univ Montpellier EuroMov Digital Hlth Mot IMT Mines Ales Montpellier France Fdn Rothschild Hosp French Natl Reference Ctr Wilsons Dis Paris France Lariboisiere Univ Hosp AP HP Dept Neurol Paris France Fdn Rothschild Hosp Dept Neurol Paris France

Background/objectives: Wilson's disease (WD) is a rare genetic disorder that leads to copper overload, mainly in the liver then, in the brain. Patients with WD often complain about sleep disorders. We aimed to explore them. Patients/methods: Sleep complaints and disease symptoms were compared in 40 patients with WD (20 patients with hepatic phenotype matched to 20 neurologic one) and 40 age, sex and BMI matched healthy controls. Results: Patients with WD had more frequently (32.5 vs 10.0%, p restless legs syndrome and obstructive sleep apnea syndrome. Patients did not report cataplexia. Conclusion: In patients with WD, insomnia and REM sleep behavior disorder are the two main sleep complaints. Insomnia is more frequent in neurologic than hepatic form of the disease. Severity of insomnia is associated with the severity of depressive symptoms. (C) 2020 Elsevier B.V. All rights reserved.

关键词： Wilson's disease Insomnia REM sleep Behavior disorder Depression restless legs syndrome

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