Effects of 24-h Transdermal Delivery of Rotigotine on the Core Symptoms and Symptom Impact of Restless Legs Syndrome/Willis-Ekbom Disease: A Post Hoc Analysis of IRLS Single Item Data from a 6-Month Placebo-Controlled European Study (P04.037)

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.

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Where Is the Core of the Volcano? The Undetermined Origin of Primary Restless Legs Syndrome

International Journal of Neuroscience ◽

10.3109/00207454.2010.537413 ◽

2010 ◽

Vol 121 (3) ◽

pp. 130-136 ◽

Cited By ~ 5

Author(s):

Baris Isak ◽

Kadriye Agan ◽

Aslihan Ergun ◽

Aslican Cakkalkurt ◽

Kayihan Uluc ◽

...

Keyword(s):

Restless Legs Syndrome ◽

Restless Legs ◽

The Core

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Emotion Processing Deficit in Euthymic Bipolar Disorder: A Potential Endophenotype

Indian Journal of Psychological Medicine ◽

10.1177/02537176211026795 ◽

2021 ◽

pp. 025371762110267

Author(s):

Preethi V. Reddy ◽

Saravanakumar Anandan ◽

Gopalkumar Rakesh ◽

Venkatarama Shivakumar ◽

Boban Joseph ◽

...

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Emotion Processing ◽

Cognitive Strategies ◽

Facial Emotion ◽

Healthy Controls ◽

Post Hoc Analysis ◽

The Core ◽

Significant Deficit ◽

Post Hoc

Background: Emotion processing deficits have been described in patients with bipolar disorder (BD) and are considered one of the core cognitive abnormalities in BD with endophenotype potential. However, the literature on specific impairments in emotion processing cognitive strategies (directive/cortical/higher versus intuitive/limbic/lower) in euthymic adult BD patients and healthy first-degree relatives/high-risk (HR) subjects in comparison with healthy controls (HCs) is sparse. Methods: We examined facial emotion recognition deficits (FERD) in BD ( N = 30), HR ( N = 21), and HC ( N = 30) matched for age (years), years of education, and sex using computer-administered face emotions–Matching And Labeling Task (eMALT). Results: The three groups were significantly different based on labeling accuracy scores for fear and anger (FA) (P < 0.001) and sad and disgust (SD) (P < 0.001). On post-hoc analysis, HR subjects exhibited a significant deficit in the labeling accuracy of FA facial emotions (P < 0.001) compared to HC. The BD group was found to have significant differences in all FA (P = 0.004) and SD (P = 0.003) emotion matching as well as FA (P = 0.001) and SD (P < 0.001) emotion labeling accuracy scores. Conclusions: BD in remission exhibits FERD in general, whereas specific labeling deficits of fear and anger emotions, indicating impaired directive higher order aspect of emotion processing, were demonstrated in HR subjects. This appears to be a potential endophenotype. These deficits could underlie the pathogenesis in BD, with possible frontolimbic circuitry impairment. They may have potential implications in functional recovery and prognosis of BD.

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Sooner Than Later If Not Right After Stroke

Sleep Disorders ◽

10.1093/med/9780190671099.003.0055 ◽

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.

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