scholarly journals Sooner Than Later If Not Right After Stroke

2019 ◽  
pp. 927-950
Author(s):  
Amy K. Dadisman ◽  
Noah D. Andrews ◽  
Reena Mehra ◽  
Irene L. Katzan
Keyword(s):  
Restless Legs Syndrome ◽  
Cerebral Autoregulation ◽  
Recurrent Stroke ◽  
Controlled Trial ◽  
Central Sleep Apnea ◽  
Restless Legs ◽  
Post Hoc ◽  
The Impact ◽  
First Time ◽  
Very High

The case involves a patient with interrelated sleep symptoms related to central hypersomnia, restless legs syndrome, and sleep disordered breathing (SDB) occurring after stroke. The prevalence of SDB after stroke has been noted to be very high, up to 70%, and consists of a higher contribution of central sleep apnea compared to the general population. Recurrent stroke is associated with a higher prevalence of SDB compared to first-time stroke. Contributions to SDB as related to stroke do not appear to have consistencies in terms of location and size of stroke. Untreated SDB can also contribute to stroke risk, with mechanisms involving increased systemic inflammation, prothrombotic biochemical markers, and dysfunction of cerebral autoregulation. Although there are post-hoc subgroup data in a randomized controlled trial suggesting reduction in stroke outcomes when SDB is treated with positive airway pressure, overall there are few studies that have rigorously examined the impact of treatment. Hypersomnia can be treated with modafinil and restless legs syndrome may become manifest due to sleep fragmentation.

scholarly journals Birds of a Feather Flock Together: Disadvantageous Decision Making in Augmented Restless Legs Syndrome Patients with and without Impulse Control Disorders

2021 ◽  
Vol 11 (3) ◽  
pp. 383
Author(s):  
Beatrice Heim ◽  
Philipp Ellmerer ◽  
Ambra Stefani ◽  
Anna Heidbreder ◽  
Elisabeth Brandauer ◽  
...  
Keyword(s):  
Decision Making ◽  
Restless Legs Syndrome ◽  
Impulse Control ◽  
Compulsive Sexual Behavior ◽  
Structured Interviews ◽  
Restless Legs ◽  
Information Sampling ◽  
Patient Groups ◽  
Post Hoc ◽  
Beads Task

Background: Augmentation (AUG) in patients with restless legs syndrome (RLS) can be associated with impulse control disorder (ICD) symptoms, such as compulsive sexual behavior, gambling disorder or compulsive shopping. In this study, we wanted to assess whether RLS patients with AUG differ in decision making from those patients who have augmentation and in addition ICD symptoms (AUG + ICD) in a post hoc analysis of a patient cohort assessed in a previous study. Methods: In total, 40 RLS patients with augmentation (19 AUG + ICD, 21 AUG without ICDs) were included. RLS diagnosis, severity, and diagnosis of augmentation were made by sleep disorder specialists. ICD symptoms were assessed using semi-structured interviews. All patients performed the beads task, which is an information sampling task where participants must decide from which of the two cups colored beads were drawn. Results were compared to 21 healthy controls (HC). Results: There was no difference in information sampling or irrational decision making between AUG and AUG + ICD patients (p = 0.67 and p = 1.00, respectively). Both patient groups drew less beads and made more irrational decisions than HC (all p-values < 0.03, respectively). Conclusions: Our results suggest that augmentation itself is associated with poorer decision making even in the absence of ICD symptoms. Further studies are necessary to explore whether rapid and hasty decision making are a harbinger of augmentation in RLS.

Cabergoline compared to levodopa in the treatment of patients with severe restless legs syndrome: Results from a multi-center, randomized, active controlled trial

2007 ◽  
Vol 22 (5) ◽  
pp. 696-703 ◽  
Author(s):  
Claudia Trenkwalder ◽  
Heike Benes ◽  
Ludger Grote ◽  
Svenja Happe ◽  
Birgit Högl ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Controlled Trial ◽  
Restless Legs

Abstract WP366: Exploring the Association Between Physician Trust and Recurrent Stroke and Transient Ischemic Attack (TIA)

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Anita Venkatesan ◽  
Bernadette Boden-Albala ◽  
Nina Parikh ◽  
Emily Goldmann
Keyword(s):  
Sex Education ◽  
Medication Compliance ◽  
Recurrent Stroke ◽  
Controlled Trial ◽  
National Study ◽  
Stroke Severity ◽  
Positive Health ◽  
Physician Trust ◽  
Ischemic Attack ◽  
The Impact

Purpose: More positive health behaviors, fewer symptoms, higher quality of life, and greater treatment satisfaction have been reported among those with greater physician trust. This study assessed the relationship between physician trust and recurrent stroke/TIA within 1 year of discharge among stroke survivors in Northern Manhattan. Methods: This study used data from the Stroke Warning Information and Faster Treatment (SWIFT) study, a randomized controlled trial conducted from 2005-2012 in a multiethnic cohort of 1,193 mild/moderate ischemic stroke and TIA survivors. The goal was to assess the impact of a stroke preparedness educational intervention on emergency department arrival time after subsequent stroke symptom onset. Physician trust, assessed at baseline, was measured with one item: “What percentage of the time do you trust doctors?”. For the analysis, it was dichotomized with the cutoff at 80%. Recurrent stroke/TIA was assessed at 1 month and 1 year. The association between recurrent stroke/TIA and patient trust was evaluated using multivariate logistic regression adjusted for sociodemographics and comorbidities. Results: In the analytic sample (n=1108), those who answered both exposure and outcome, the prevalence of recurrent stroke/TIA and lack of physician trust was 10.75% and 36.46%, respectively. Consistent with the literature, Hispanics compared to whites had a higher prevalence of lack of physician trust (42.71% vs. 34.11%, p<0.001). Adjusting for race/ethnicity, intervention status, age, sex, education, marital status, smoking, insurance, hypertension, diabetes, body mass index, physical activity, and depression, those who lacked trust had greater odds of recurrent stroke/TIA (OR=1.36, 95% CI:0.86-2.18) than those who had trust. When observing the association among Hispanics and Blacks, those who lacked trust had (OR=1.27, 95% CI: 0.66-2.42) and (OR=1.26, 95% CI: 0.36-4.38) respectively, greater odds of a recurrent episode than those who had trust. Conclusion: Despite insignificant findings, a national study with a greater range of stroke severity and additional measures such as medication compliance may be warranted to provide greater insight on the effects of physician trust on stroke outcomes.

scholarly journals Evaluation of Acupuncture in the Treatment of Restless Legs Syndrome: A Randomized Controlled Trial

2017 ◽  
Vol 10 (5) ◽  
pp. 346-350 ◽  
Author(s):  
Gholam Reza Raissi ◽  
Bijan Forogh ◽  
Tannaz Ahadi ◽  
Samaneh Ghahramanpoori ◽  
Pouya Ghaboussi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Restless Legs Syndrome ◽  
Controlled Trial ◽  
Restless Legs ◽  
Randomized Controlled

scholarly journals Accelerometer-Measured Physical Activity and Its Impact on Sleep Quality in Persons Suffering From Restless Legs Syndrome

2020 ◽  
Author(s):  
Anne Reimers ◽  
Verena Heidenreich ◽  
Hans-Joachim Bittermann ◽  
Guido Knapp ◽  
Carl-Detlev Reimers
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Negative Correlation ◽  
Restless Legs Syndrome ◽  
Quality Parameters ◽  
Moderate Physical Activity ◽  
Activity Levels ◽  
Restless Legs ◽  
Physical Activity Levels ◽  
The Impact

Abstract Background: Main symptoms of the restless legs syndrome (RLS) are sleep onset insomnia and difficulty to maintain sleep. Previous studies showed that regular physical activity can reduce the risk of developing RLS. However, the relationships of physical activity on sleep quality parameters in subjects suffering from RLS have not been investigated by applying accelerometry. Thus, the present study investigates the impact of physical activity during the day (7-12 h, 12-18 h, 18-23 h) on sleep quality in subject suffering from idiopathic RLS as well as their intensity and extent of physical activity by applying a real-time approach.Methods: In a sample of 47 participants suffering from idiopathic RLS, physical activity and sleep quality were captured over one week by using accelerometers. For data analysis physical activity levels and step counts during three periods of a day (morning, afternoon, evening) were correlated with sleep quality parameters of the following night.Results: In this observational study, significant correlations of physical activity with the sleep parameters were rarely confirmed (exception: negative correlation of steps in the morning with periodic leg movements in sleep and negative correlation of physical activity in the evening and total sleep period). However, the physical activity levels of the participants were unexpectedly high compared to population-level data and variance in physical activity was low. The average activity was 13,817 (SD=4,086) steps and 347 (SD=117) minutes of moderate physical activity per day in females and 10,636 (SD=3,748) steps and 269 (SD=69) minutes of moderate physical activity in males, respectively. However, the participants conducted no vigorous physical activity.Conclusions: To investigate the effects of daily physical activity and RLS symptoms interventional studies with different intensities of physical activities at different points of time during the day are needed.

Prenatal exercise and cardiovascular health (PEACH) study: impact of acute and chronic exercise on cerebrovascular hemodynamics and dynamic cerebral autoregulation

2021 ◽  
Author(s):  
Rachel J. Skow ◽  
Lawrence Labrecque ◽  
Jade A. Rosenberger ◽  
Patrice Brassard ◽  
Craig D. Steinback ◽  
...  
Keyword(s):  
Exercise Training ◽  
Gestational Age ◽  
Cerebral Autoregulation ◽  
Acute Exercise ◽  
Controlled Trial ◽  
Moderate Intensity ◽  
Chronic Exercise ◽  
Arterial Blood ◽  
The Impact ◽  
Dynamic Cerebral Autoregulation

We performed a randomised controlled trial measuring dynamic cerebral autoregulation (dCA) using a sit-to-stand maneuver before (SS1) and following (SS2) an acute exercise test at 16-20 weeks gestation (trimester 2; TM2) and then again at 34-37 weeks gestation (third trimester; TM3). Following the first assessment, women were randomised into exercise training or control (standard care) groups; women in the exercise training group were prescribed moderate intensity aerobic exercise for 25-40 minutes on 3-4 days per week for 14±1weeks. Resting seated mean blood velocity in the middle cerebral artery (MCAvmean) was lower in TM3 compared to TM2 but not impacted by exercise training intervention. dCA was not impacted by gestational age, or exercise training during SS1. During SS2, dCA was altered such that there were greater absolute and relative decreases in mean arterial blood pressure (MAP) and MCAvmean, but this was not impacted by the intervention. There was also no difference in the relationship between the decrease in MCAvmean compared to the decrease in MAP (%/%), or the onset of the regulatory response with respect to acute exercise, gestational age, or intervention; however, rate of regulation was faster in women in the exercise group following acute exercise (interaction effect, p=0.048). These data highlight the resilience of the cerebral circulation in that dCA was well maintained or improved in healthy pregnant women between TM2 and TM3. However, future work addressing the impact of acute and chronic exercise on dCA in women who are at risk for cardiovascular complications during pregnancy is needed.

Effects of repetitive paired associative stimulation on brain plasticity and working memory in Alzheimer’s disease: a pilot randomized double-blind-controlled trial

2020 ◽  
pp. 1-13
Author(s):  
Sanjeev Kumar ◽  
Reza Zomorrodi ◽  
Zaid Ghazala ◽  
Michelle S. Goodman ◽  
Daniel M. Blumberger ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Brain Plasticity ◽  
Controlled Trial ◽  
Memory Performance ◽  
Double Blind ◽  
Paired Associative Stimulation ◽  
Post Hoc ◽  
The Impact

ABSTRACT Design: Pilot randomized double-blind-controlled trial of repetitive paired associative stimulation (rPAS), a paradigm that combines transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) with peripheral median nerve stimulation. Objectives: To study the impact of rPAS on DLPFC plasticity and working memory performance in Alzheimer’s disease (AD). Methods: Thirty-two patients with AD (females = 16), mean (SD) age = 76.4 (6.3) years were randomized 1:1 to receive a 2-week (5 days/week) course of active or control rPAS. DLPFC plasticity was assessed using single session PAS combined with electroencephalography (EEG) at baseline and on days 1, 7, and 14 post-rPAS. Working memory and theta–gamma coupling were assessed at the same time points using the N-back task and EEG. Results: There were no significant differences between the active and control rPAS groups on DLPFC plasticity or working memory performance after the rPAS intervention. There were significant main effects of time on DLPFC plasticity, working memory, and theta–gamma coupling, only for the active rPAS group. Further, on post hoc within-group analyses done to generate hypotheses for future research, as compared to baseline, only the rPAS group improved on post-rPAS day 1 on all three indices. Finally, there was a positive correlation between working memory performance and theta–gamma coupling. Conclusions: This study did not show a beneficial effect of rPAS for DLPFC plasticity or working memory in AD. However, post hoc analyses showed promising results favoring rPAS and supporting further research on this topic. (Clinicaltrials.gov-NCT01847586)

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