Restless leg syndrome is a condition that can severely impact its victim’s ability to relax and sleep. Its causes have been a mystery, and in fact it was only fairly recently that it was recognized as being legitimate. A new study, however, may be zeroing in on its cause.
Johns Hopkins Medicine researchers say new experiments using magnetic pulse brain stimulation on people with moderate to severe restless legs syndrome (RLS) have added to evidence that the condition is due to excitability and hyperarousal in the part of the brain’s motor cortex responsible for leg movement.
The researchers say their findings may help devise safer, more effective ways to treat RLS and the chronic sleep deprivation it causes, using electrical or magnetic pulses to calm or interrupt the hyperarousal. Some 10 percent of adults in the U.S. experience RLS at one time or another, and about 1 in 500 report that the condition is severe and chronic enough to interfere with their quality of life, work productivity or mental health, according to the National Sleep Foundation.
People with severe RLS describe symptoms of the condition as an overwhelming urge to move their legs when they are at rest. They may feel pain, or the sensation of soda bubbles in their veins or worms crawling in their legs, with relief coming only when standing or deliberately moving their legs. Long-term effects include fatigue, anxiety and depression, much of it linked to repeated interruption of sound sleep. Standard treatments, which may carry significant side effects, include medications that behave like the neurotransmitter dopamine, opioids and anti-seizure drugs.
Although many conditions, such as kidney disease and diabetes, have been associated with RLS, the neurological roots of the condition have been subject to much debate.
The new study, the Johns Hopkins researchers say, supports the idea that the underlying mechanism for RLS rests in the brain’s “move my legs” center and makes even more sense of the relief those with RLS experience when they get up and move them.
“Essentially the brain sends the signal when it’s preparing to move a limb, even when you aren’t planning to move, so your body is ready and amped up,” says Richard Allen, Ph.D., professor of neurology at the Johns Hopkins University School of Medicine. “The only way to alleviate the feeling is to move.”
Medications that act like the neurotransmitter dopamine, such as ropinirole or pramipexole, work on RLS in the short term but can exacerbate the condition over time. Opioids are effective, but not ideal due to their risk for dependency. With the results of this new study, the researchers are hoping to develop a system of electrical stimulation to suppress the brain’s activity. Planning of these studies is in the works.
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