Ulm, Univ., Diss., 2008.

Restless legs syndrome (RLS) is a sensorimotor disorder that often starts at a young age and has a chronic progression throughout life. It has a very high incidence, affecting 10% of the general population. The majority of cases are familial and the genetic nature of the disorder has been demonstrated in twin studies. RLS segregates in an autosomal dominant way in the majority of families. This data has incited a search for genetic factors responsible for RLS using linkage as the approach. Dr. Rouleau's laboratory has one of the world's largest collections of RLS pedigrees. These families are mostly of French Canadian (FC) origin. / Using these families, two novel candidate loci, on chromosomes 16p and 20p, were discovered. Also, previously described candidate loci on chromosomes 9p and 14q were replicated in this cohort of families. / A duplication of a large part of a functional candidate gene in the locus on chromosome 20, Signal Regulatory Protein beta 1 (SIRPB1), was discovered in individuals affected with RLS from a FC pedigree, in which linkage to this locus was described. The duplication segregates with the disease status in the family, but its role in RLS pathogenesis has yet to be demonstrated. / No disease-causing mutations were discovered in the chromosome 16 locus. Analysis of several functional and positional candidate genes in previously described loci on chromosomes 12 and 14 did not reveal disease-causing mutations. / A follow up of these studies is necessary in order to confirm the implication of SIRPB1 in RLS pathogenesis, and to detect novel gene(s) whose deregulation leads to this disorder.

M.Dip.Tech. (Homoeopathy) / The aim of the study was to compare the effectiveness of the Homoeopathic simplex Zincum metallicum in a D6 potency with the Homoeopathic complex treatment Spascupreel in Restless leg syndrome sufferers in terms ofpatient response to treatment. It was hypothesised that the Homoeopathic simplex Zincum metallicum in a D6 potency.Both the homoeopathic simplex Zincum metallicum D6 preparation and homoeopathic complex Spascupreel preparation was found to bring about an improvement in the symptoms ofrestless leg syndrome. However Zincum metallicum D6 showed a much greater improvement that was statistically significant. and the Homoeopathic complex Spascupreel would result in a substantial improvement in all the clinical aspects ofRestless leg syndrome sufferers, and that it could be used as an alternative to "conventional" treatment in many cases. The study, conducted over a period of 3 months, was a clinical trial, in which a placebo control group was compared with two experimental groups. Convenience sampling was used to draw patients into the trial. Volunteers responded to advertisements, which had been placed in various advertising media. The persons who responded to the advertisements were requested to complete Questionnaires one and two and of those who met the criteria, which clearly indicated that they were sufferers of Restless leg syndrome, a maximum of 30 volunteers were accepted for the study. An independent party randomly divided the participants into three groups and the study was conducted over a period ofthree months. During this period 10 of the participants received placebo treatment, 10 received the Homoeopathic simplex Zincum metallicum in a D6 potency and 10 received the Homoeopathic complex Spascupreel. Being a double-blind study neither the researcher nor the participants knew what type of treatment they received until the end of the research. The participants who fell into the placebo group were given the opportunity after the study to be treated with Homoeopathic simplex or complex treatment depending on the effectiveness.

Introduction: Restless legs syndrome (RLS) is a common neurological disorder affecting 10% of the population. Most antidepressants exacerbate symptoms; however, correlational studies have noted symptom improvement with bupropion. The purpose of the current study was to examine whether, in a controlled study, bupropion would improve the symptoms of RLS, or at least not exacerbate them. Methods: This was a double-blinded, randomized controlled trial. Twenty-nine participants with moderate to severe RLS received 150 mg sustained-release bupropion once daily, and 31 control participants received a placebo. Participants were followed for 6 weeks and completed standardized tools, including the International Restless Legs Syndrome Study Group (IRLSSG) severity scale. Results: The primary outcome was change from baseline in IRLSSG severity score; lower scores were associated with improved symptoms. At 3 weeks, IRLSSG scores were 10.8 points lower in the bupropion group and 6.0 points lower in the placebo group (P = .016). At 6 weeks, IRLSSG scores were 10.4 points lower in the bupropion group and 7.6 points lower in the placebo group (P = .108). Bupropion was more effective than placebo in the treatment of RLS at 3 weeks; however, this difference was not statistically significant at 6 weeks. Conclusions: The data from our study suggest that bupropion does not exacerbate the symptoms of RLS and may be a reasonable choice if an antidepressant is needed in individuals with RLS. Larger studies that include titration of bupropion should be considered to determine if bupropion is appropriate for primary treatment of RLS, particularly considering the lower cost and favorable side effect profile compared with currently recommended first-line dopamine agonists.

No description available.

thesis submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree Doctor of Philosophy. Johannesburg, 2013 / Restless Legs Syndrome (RLS) and Periodic Limb Movements (PLM) are common neurological disorders for which the underlying aetiology is not fully understood. Currently RLS and PLM are thought to be caused by a central deficiency of dopamine or other functional abnormalities of the central nervous system. The work included in this thesis investigated different new methods of assessing the sensory and motor features of RLS and PLM, in an attempt to extend our understanding of their aetiology and improve the accuracy of diagnosis of these conditions. The first two studies in the thesis described and characterized the sensations of RLS symptoms, and whether they are influenced by the presence of pain, in an English speaking South African population. The most frequently cited descriptors were different to those used in the current RLS diagnostic criteria. Inclusion of the most commonly used RLS descriptors in the diagnostic criteria may help to improve the accuracy of RLS diagnosis. Patients who experienced painful RLS had greater McGill Pain Questionnaire scores and used different terms to describe their RLS to those that did not have painful RLS sensations. The third project quantified the responses of the Hoffman and patellar reflexes in RLS patients using electromyography and kinematics. The RLS patients exhibited hyporeflexia in the evening compared to the morning, and compared to control participants. This data suggests that RLS is not the result of a global state of hyperexcitability, as the literature suggests, but may reflect more discrete functional abnormalities of the spinal cord. A diurnal variation in the patellar reflex was found, supporting the notion of circadian variations of spinal excitability in RLS patients. The final investigation assessed the sensory qualities (discomfort and pain) of RLS in conjunction with motor activity evoked by using the Suggested Immobilization Test. Despite rating significant levels of discomfort, the majority of the RLS patients did not exhibit PLM; possibly suggesting a disconnect between the sensory and motor components of RLS. In conclusion, it is the major finding of this thesis that inclusion of new assessment techniques for the measurement of sensory and motor features of RLS and PLM provides both new insights and potential clinical tools enhancing our understanding of these disorders.

Purpose: A key objective feature in Restless Legs Syndrome (RLS) is the presence of Periodic Limb Movements (PLMs). The gold standard for documenting PLMs is through polysomnogram (PSG), an overnight sleep study in a sleep laboratory, which is expensive and often inaccessible. This work explored the ability of a portable sleep monitor (PM) to reliably record surface EMG signals, to reliably record limb movements overnight in comparison with PSG, and examined intra- and inter-rater reliability for scoring the PM recordings. Methods: The PM’s surface EMG channel was tested against a standard EMG amplifier by recording bilateral tibialis anterior muscle activity in five healthy participants. It was also tested for recording PLMs simultaneously with polysomnography at Kingston General Hospital with 40 participants referred for screening of sleep disorders. PLMs were scored using standard criteria according to the American Academy of Sleep Medicine Scoring Manual (2007) Analyses: Comparison between the two methods of surface EMG recording was through counts of muscle activity bursts. Comparison of overnight PLM counts was through t-test, Pearson’s r, Intraclass Correlation Coefficient (ICC) and Bland-Altman plots. Intra-rater reliability and inter-rater reliability between two analysts was examined by ICC. Results: Examination of the PM surface EMG recordings demonstrated an exact match of muscle activity counts between the PM and standard EMG recordings. In the PSG study, mean difference between the two PLMI values was +4.8 ± 11.1, t (34) = 2.1, p = 0.04, which was statistically significant and demonstrated systematic over-reporting by the portable monitor. The two PLMI values were strongly correlated, giving a Pearson’s r = .87, p < 0.001. ICC for absolute agreement was 0.87, (95% CI, 0.76 – 0.93), p < 0.001. Bland-Altman analysis gave 95% limits of agreement between the two PLM Indices as +27.9 (95% CI +33.0 to 20.2) to – 19.3 (95%CI -10.6 to -23.4). Conclusions: These data suggest there may be sufficient agreement between PLMI collected by PM and polysomnography to support the use of the PM for measuring PLMs. Further testing should address test retest reliability and examine the performance of the PM in a wider patient population. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2012-08-24 16:40:03.381

Age of information (AoI) captures the freshness of information and has been used broadly for scheduling data transmission in the Internet of Things (IoT). We consider a general scenario where a meaningful piece of information consists of multiple packets and the information would not be considered complete until all related packets have been correctly received. This general scenario, seemingly a trivial extension of exiting work where information update is in terms of single packet, is actually challenging in both scheduling algorithm design and theoretical analysis, because we need to track the history of received packets before a complete piece of information can be updated. We first analyse the necessary condition for optimal scheduling based on which we present an optimal scheduling method. The optimal solution, however, has high time complexity. To address the problem, we investigate the problem in the framework of restless multi-armed bandit (RMAB) and propose an index-based scheduling policy by applying Whittle index. We also propose a new transmission strategy based on erasure codes to improve the performance of scheduling policies in lossy networks. Performance evaluation results demonstrate that our solution outperforms other baseline policies such as greedy policy and naive Whittle index policy in both lossless and lossy networks. / Graduate

No description available.

Background: Symptoms of anxiety and depression in patients with restless legs syndrome (RLS) have been observed. However, it is unclear whether rates of threshold depression and anxiety disorders according to DSM-IV criteria in such patients are also elevated. Methods: 238 RLS patients were assessed with a standardized diagnostic interview (Munich- Composite International Diagnostic Interview for DSM-IV) validated for subjects aged 18–65 years. Rates of anxiety and depressive disorders were compared between 130 RLS patients within this age range and 2265 community respondents from a nationally representative sample with somatic morbidity of other types. Results: RLS patients revealed an increased risk of having 12-month anxiety and depressive disorders with particularly strong associations with panic disorder (OR=4.7; 95% CI=2.1–10.1), generalized anxiety disorder (OR=3.5; 95% CI= 1.7–7.1), and major depression (OR=2.6; 95% CI=1.5–4.4). In addition, lifetime rates of panic disorder and most depressive disorders as well as comorbid depression and anxiety disorders were considerably increased among RLS patients compared with controls. Conclusions: The results suggest that RLS patients are at increased risk of having specific anxiety and depressive disorders. Causal attributions of patients suggest that a considerable proportion of the excess morbidity for depression and panic disorder might be due to RLS symptomatology.