Navegando por Palavras-chave "Restless Legs Syndrome"
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- ItemSomente MetadadadosDistúrbios do sono em esclerose múltipla: estudo observacional, comparativo, entre pacientes com esclerose múltipla e a população da cidade São Paulo acompanhada no Episono(Universidade Federal de São Paulo (UNIFESP), 2020-09-24) Toscano, Vanessa Granato [UNIFESP]; Oliveira, Enedina Maria Lobato De [UNIFESP]; Universidade Federal de São PauloIntroduction: Sleep disorders lead to imbalance and disease and their recognition and treatment are important for maintaining health. Some sleep disorders are very prevalent in the general population, and especially in diseases such as multiple sclerosis. Objectives: To compare sleep complaints, chronotype, fatigue and depression found in adult multiple sclerosis patients followed at the Demyelinating Disease Outpatient Clinic of the Neurology Discipline, Escola Paulista de Medicina - UNIFESP, with the population of São Paulo studied in the Episono. Methods: A case-control, comparative study conducted between March and December 2016, through interviews with patients and application of the main questionnaires for sleep, chronotype, fatigue and depression evaluation. The scores of the questionnaires were compared to those of the control group, using MANOVA to evaluate the effects. Age, sex, and physical activity were added as covariates. The ANOVA for each dependent variable was conducted as a follow-up test to the MANOVA and was statistically significant. Finally, propensity score matching was applied to reduce bias in the estimation of differences between the two populations. Results: The control group had worse sleep quality and more excessive sleepiness than patients with MS. Sleep apnea was more prevalent in the Episono group, as was restless legs syndrome. There was no difference in chronotype between the two groups, both having morning and intermediate individuals. Fatigue was intensively present in the MS group and was not associated with sleep quality or excessive daytime sleepiness. Women in both groups had worse sleep quality and more depression, and depression was negatively associated with exercise. Conclusion: Patients with multiple sclerosis regularly treated presented with less prevalence of sleep complaints than the city of São Paulo population. The chronotype of these patients was not different from other individuals dwelling in the city. Fatigue is a common and intense symptom in multiple sclerosis and was not related to sleep disorders in this study, neither was depression.
- ItemSomente MetadadadosThe duration of the cortical silent period is not abnormal in Restless Legs Syndrome/Willis-Ekbom Disease(Elsevier Science Bv, 2017) Queiroz de Paiva, Joselisa Peres; Magalhaes, Samir Camara; do Prado, Gilmar Fernandes [UNIFESP]; Eckeli, Alan Luiz; Kaelin-Lang, Alain; Conforto, Adriana BastosObjective: To compare the duration of the cortical silent period (CSP) measured in a hand muscle in subjects with primary Restless Legs Syndrome (RLS/WED) and controls, using four different methods of analysis. Methods: The CSP to transcranial magnetic stimulation of the dominant motor cortex was assessed in the abductor digiti minimi of 33 subjects with RLS/WED and 24 controls. CSP duration was measured by an automated and three visually-guided methods. Results: There were significant differences between absolute values of CSP duration according to the method of analysis. However, irrespectively of the method used for CSP assessment, no differences were found between measurements performed in subjects with RLS/WED and subjects from the control group. Conclusions: Absolute values of CSP durations analyzed by different methods should not be directly compared, because significantly different results can be obtained from the same data set. Significance: The CSP assessed from a hand muscle is unlikely to be a biomarker of primary RLS/WED. Our results highlight the importance of standardizing the definition of CSP onset and offset, as well as of describing in detail the methodology chosen to record and measure CSP duration, in order to enable comparisons between studies. (C) 2016 Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis(Faculdade de Medicina / USP, 2010-01-01) Pereira Junior, Jose Carlos; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Pessoa, Hugo de Lins; Faculdade de Medicina de Jundiaí Departamento de Pediatria; Universidade Federal de São Paulo (UNIFESP)Data collected from medical literature indicate that dopaminergic agonists alleviate Restless Legs Syndrome symptoms while dopaminergic agonists antagonists aggravate them. Dopaminergic agonists is a physiological regulator of thyroid-stimulating hormone. Dopaminergic agonists infusion diminishes the levels of thyroid hormones, which have the ability to provoke restlessness, hyperkinetic states, tremors, and insomnia. Conditions associated with higher levels of thyroid hormones, such as pregnancy or hyperthyroidism, have a higher prevalence of Restless Legs Syndrome symptoms. Low iron levels can cause secondary Restless Legs Syndrome or aggravate symptoms of primary disease as well as diminish enzymatic activities that are involved in dopaminergic agonists production and the degradation of thyroid hormones. Moreover, as a result of low iron levels, dopaminergic agonists diminishes and thyroid hormones increase. Iron therapy improves Restless Legs Syndrome symptoms in iron deprived patients. Medical hypothesis. To discuss the theory that thyroid hormones, when not counterbalanced by dopaminergic agonists, may precipitate the signs and symptoms underpinning Restless Legs Syndrome. The main cause of Restless Legs Syndrome might be an imbalance between the dopaminergic agonists system and thyroid hormones.
- ItemAcesso aberto (Open Access)Restless legs syndrome in subjects with a knee prosthesis: evidence that symptoms are generated in the periphery(Faculdade de Medicina / USP, 2011-01-01) Pereira Júnior, José Carlos; Silva Neto, João Luiz Pereira da; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Faculdade de Medicina de Jundiaí; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: There are no data adressing the prevalence of restless legs syndrome in subjects who have knee prosthesis. Therefore, we conducted a cross-sectional survey of subjects who underwent knee prosthesis surgery. METHOD: A total of 107 subjects (30 male, 77 female) were interviewed over the telephone regarding restless legs syndrome symptoms. If the patients exhibited symptoms of the syndrome, we conducted face-to-face interviews. Lastly, a therapeutic test with pramipexole was proposed for each subject. RESULTS: In our cohort, 7 males (23%) and 30 females (39%) had restless legs syndrome. Of these, 6 males and 23 females were submitted to face-to-face-interview. Of the males, 5 (83%) had restless legs after the knee surgeryexclusively in the operated leg- and reported no family restless legs history. One man had a prior case of bilateral restless legs syndrome, a positive family history and claimed exacerbation of symptoms in the operated leg. Among the females, 16 (69%) had restless legs prior to surgery. A total of 10 female patients reported bilateral symptoms, with fewer symptoms in the operated leg, while 6 displayed a worse outcome in the operated leg. The 7 females (31%) without restless legs prior to surgery and without a family history experienced symptoms only in the operated leg. All subjects responded favorably to the pramipexole therapeutic test. CONCLUSION: Our results suggest that secondary unilateral restless legs syndrome may ensue from knee prosthesis surgery and that the symptoms are generated in the peripheral nervous system.
- ItemAcesso aberto (Open Access)Saint John's wort, an herbal inducer of the cytochrome P4503A4 isoform, may alleviate symptoms of Willis-Ekbom's disease(Faculdade de Medicina / USP, 2013-04-01) Pereira Junior, José Carlos; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Alves, Rosana Cardoso; Faculdade de Medicina de Jundiaí Pediatria; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: Certain drug classes alleviate the symptoms of Willis-Ekbom's disease, whereas others aggravate them. The pharmacological profiles of these drugs suggest that drugs that alleviate Willis-Ekbom's disease inhibit thyroid hormone activity, whereas drugs that aggravate Willis-Ekbom's disease increase thyroid hormone activity. These different effects may be secondary to the opposing actions that drugs have on the CYP4503A4 enzyme isoform. Drugs that worsen the symptoms of the Willis-Ekbom's disease inhibit the CYP4503A4 isoform, and drugs that ameliorate the symptoms induce CYP4503A4. The aim of this study is to determine whether Saint John's wort, as an inducer of the CYP4503A4 isoform, diminishes the severity of Willis-Ekbom's disease symptoms by increasing the metabolism of thyroid hormone in treated patients. METHODS: In an open-label pilot trial, we treated 21 Willis-Ekbom's disease patients with a concentrated extract of Saint John's wort at a daily dose of 300 mg over the course of three months. RESULTS: Saint John's wort reduced the severity of Willis-Ekbom's disease symptoms in 17 of the 21 patients. CONCLUSION: Results of this trial suggest that Saint John's wort may benefit some Willis-Ekbom's disease patients. However, as this trial was not placebo-controlled, the extent to which Saint John's wort is effective as a Willis-Ekbom's disease treatment will depend on future, blinded placebo-controlled studies.