Guidelines for First-line Treatment of RLS, Prevention and Treatment of Augmentation


SLEEP MEDICINE Journal:

Title:  Guidelines for the first-line treatment of restless legs syndrome/Willis–Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-Foundation
ISSN: 1389-9457
DOI: 10.1016/j.sleep.2016.01.017
URL: http://dx.doi.org/10.1016/j.sleep.2016.01.017

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WHITE PAPER SUMMARY OF RECOMMENDATIONS FOR THE PREVENTION AND TREATMENT OF RLS/WED AUGMENTATION
A COMBINED TASK FORCE OF THE IRLSSG, EURLSSG AND THE RLS‐FOUNDATION

Click on below link to download the paper.   For permission to reproduce or distribute the paper contact secretary@irlssg.org.

Click here: Summary of recommendations RLS Augmentation 13Aug2015 (PDF)
(updated on August 13, 2015 with corrected serum ferritin level)

Members of the Task Force

Diego Garcia‐Borreguero, MD, Madrid, Spain*
Richard P. Allen, PhD, Baltimore, MD, USA*
Michael H. Silber, MBChB, Rochester, MN, USA*
John W. Winkelman, MD, Boston, MA, USA*
Birgit Högl, MD, Innsbruck, Austria*
Jacquelyn Bainbridge, PharmD, Denver, CO, USA
Mark Buchfuhrer, MD, Downey, CA, USA
Georgios Hadjigeorgiou, MD, Thessaly, Greece
Yuichi Inoue, MD, Tokyo, Japan
Mauro Manconi, MD, Lugano, Switzerland
William Ondo, MD, Houston, TX, USA
Juliane Winkelmann, MD, Stanford, CA, USA
*Member of the writing committee

2015 Science Summit October 22-26, 2015

International RLS Study Group (IRLSSG)and European RLS Study Group (EU-RLSSG) 2015 RLS/WED SCIENCE SUMMIT

OCTOBER 22-26, 2015 held in Asilomar Conference Grounds in Pacific Grove, CA

COMMITTED TO ADVANCING BASIC AND CLINICAL RESEARCH ON RLS/WED

SYMPOSIUM SPEAKER ABSTRACTS (PDF):  RLS Science Summit abstracts ver100915

Certifiate of Attendance (PDF download):  2015 certificate of attendance – template

RLS/WED Science Summit Program Committee

Diego Garcia-Borreguero (co-chair)
Juliane Winkelmann (co-chair)

Richard Allen
WH Oertel
Daniel Picchietti
Marco Zucconi

PROGRAM

THURSDAY OCTOBER 22, 2015
Noon – 10:00pm Check-in and registration
6:00pm – 6:30pm Opening reception by Crocker Hall fire pit
6:30pm – 8:30pm BBQ dinner by Crocker Hall fire pit
8:30pm – 10:00pm Networking at social hall and fire pit

FRIDAY OCTOBER 23, 2015
7:30am – 8:00am Breakfast at Crocker Dining Hall
8:00am – 8:15am Opening session
8:15am – 9:45am Session 1 – Epidemiology
9:45am – 10:00am Coffee Break
10:00am – 12:00pm Session 2Genetics 
Noon – 1:00pm Lunch at Crocker Dining Hall
1:15pm – 3:15pm Session 3 – Animal Models for RLS Phenotype  
3:15pm – 3:30pm Coffee Break
3:30pm – 5:00pm Session 4 – Spinal and Cortical Excitability/Hyperarousal
5:00pm – 6:00pm Writing Sessions
6:00pm – 7:00pm Dinner at Crocker Dining Hall
7:30pm – 8:30pm Debate on Diagnostic Criteria: HB Lee, Dan Picchietti, Ruth O’Hare, and Art Walters
8:30pm – 9:30pm Posters and social networking; wine and cheese

SATURDAY OCTOBER 24, 2015
7:30am – 8:00am Breakfast at Crocker Dining Hall
8:00am – 9:30am Session 5 – PLMS Discussion Session
9:30am – 9:50am Coffee Break
9:50am – 11:50am Session 6 – The Role of Iron
Noon – 1:00pm Lunch at Crocker Dining Hall
1:15pm – 2:45pm Session 7 – The Dopaminergic System and RLS: Where Are We and What Next
2:45pm – 3:00pm Coffee Break
3:00pm – 4:30pm Session 8 – Opioids and Pain in RLS
4:30pm – 5:30pm Writing Session
5:00-pm – 6:00pm  Special interest group:  Priorities and avenues for NIH and other government funding (meet at Hearst Social Hall)
6:00pm – 7:00pm Dinner at Crocker Dining Hall
7:30pm – 8:30pm  PLM Detection and Associations in the Wisconsin Sleep Cohort: E Mignot
8:30pm – 9:30pm Posters and social networking; wine and cheese

SUNDAY OCTOBER 25, 2015
7:30am – 8:00am Breakfast at Crocker Dining Hall
8:10am – 9:40am Session 9 – RLS and Cardiovascular Disease: Current Evidence and a
Roadmap for Future Research
9:40am – 10:00am Coffee Break
10:00am – 11:30am Session 10 – Brain Imaging and Connectivity
Noon – 1:00pm Lunch at Crocker Dining Hall
1:15pm – 2:45pm Session 11 – New Treatment Implications of Current Science
2:45pm – 3:00pm Coffee Break
3:00pm – 4:30pm Session 12 – Clinical Updates
4:30pm – 6:00pm Writing Session
6:00pm – 7:00pm Dinner at Crocker Dining Hall
7:30pm – 8:30pm Next Generation RLS Researchers – increasing awareness on RLS
Research for Young scientists and clinicians: Wolfgang H Oertel
8:30pm – 9:30pm Discussion and next steps
9:30pm – 10:00pm Networking

MONDAY OCTOBER 26, 2015
5:00am – Noon Depart for airports
7:30am – 9:00am Breakfast at Crocker Dining Hall

SESSION 1 Epidemiology

CO-CHAIRS Daniel Picchietti & Klaus Berger

SPEAKERS AND TITLE
Daniel Picchietti
How has epidemiological research helped the field of WED/RLS?
Stephen van den Eeden
Opportunities and limits of secondary data sources in WED/RLS research
Klaus Berger
Understanding cross-cultural differences in RLS prevalence
Klaus Berger
Convergence of WED/RLS epidemiological research with genetic,biologic, and other areas of WED/RLS research
Daniel Picchietti & Klaus Berger
Summary

SESSION 2 Genetics

CO-CHAIRS Guy Rouleau & Juliane Winkelmann

SPEAKERS AND TITLE
Juliane Winkelmann
The search for common variants: GWAS studies – an update
Barbara Schormair
The search for rare variants: WES and WGS studies of RLS
Guy Rouleau
Genetic architecture of RLS, including “common variants” and
“rare variants” and thoughts about “missing heritability”
David Rye
From genotype to phenotype in RLS and PLMS
Thomas Meitinger
Summary and discussion

SESSION 3 Animal Models for RLS Phenotype

CO-CHAIRS Bryon Jones &  David Rye

SPEAKERS AND TITLE
David Rye & Byron Jones
Introduction
Juliane Winkelmann 
The role of Meis1, a gene nominated by GWAS, in behaviors mimicking RLS
Yunqing Li
The role of Btbd9, a gene nominated by GWAS, in behaviors and iron regulation related to RLS
Subhabrata Sanyal
Ubiquitination in Drosophila as related to RLS
Richard Allen
BXD 40, a mouse that when fed an iron-poor diet, exhibits endo- and exo-phenotypes mimicking RLS
Byron Jones & David Rye
Discussion

SESSION 4 Spinal and Cortical Excitability/Hyperarousal

CHAIRS Walter Paulus

SPEAKERS AND TITLE
Imad Ghorayeb
Spinal physiology in non-human primate models of RLS
Cornelius Bachmann
Physiology of spinal sensory processing in RLS alternatively RLS and its relation to pain at a spinal level
Walter Paulus
Spinal excitability and methods of stimulation
Yuping Wang
Cortical excitability
Giuseppe Lanza
Discussion on spinal and cortical excitability hyperarousal
Walter Paulus
Summary

SESSION 5 PLMS

CO-CHAIRS Raffaele Ferri &  Stephany Fulda

SPEAKERS AND TITLE
Raffaele Ferri
Neurophysiologic correlates of PLMS
Brian Koo 
PLMS as a cardiovascular risk factor: evidence and mechanisms
Stephany Fulda
Evidence-based criteria are needed to score PLMS
Dan Picchietti
Discussion on PLMS
Brian Koo, Stephany Fulda, & Raffaele Ferri
Discussion

SESSION 6 TheRole of Iron

CO-CHAIRS James Connor &  Richard Allen

SPEAKERS AND TITLE
James Connor
Blood Brain Barrier iron – CSF from RLS patient
Stephanie Patton
Iron – Hypoxia interaction: central and peripheral effects including effects on genes and peripheral myelin
Richard Allen
Pre-clinical and clinical data on effects of iron deficits and iron treatments
Konrad Oexle
Genetic factors of iron
Richard Allen & James Connor
Discussion

SESSION 7 TheDopaminergic System and RLS: Where Are We and What Next

CO-CHAIRS Chris Earley & Stefan Clemens

SPEAKERS AND TITLE
Sergi Ferre
DA receptor heteromers as possible new targets for RLS
George Uhl
DAergic systems and cell adhesion molecules. How might they inform us about RLS, augmentation, and novel therapeutic targets
Chris Earley
The state of the DAergic system in RLS
Stefan Clemens
The spinal DAergic system and relevance to RLS
Chris Earley & Stefan Clemens
Discussion

SESSION 8 Opioids and Pain in RLS

CO-CHAIRS Claudia Trenkwalder & Walter Zieglgänsberger

SPEAKERS AND TITLE
Walter Zieglgänsberger
The interaction of pain physiology and the opioid system:from animals to humans
Birgit Hogl
The contribution of sleep and sleep deprivation for pain
Sam Ahmedzai
Actions of commonly used opioid medications; mechanisms and actions of opioids
Claudia Trenkwalder
Possible mechanisms of action for opioid treatment in RLS – lessons from clinical trials
Claudia Trenkwalder
Discussion; What type of pain is occurring in RLS patients

SESSION 9 RLS and Cardiovascular Disease: Current Evidence and a Roadmap for Future Research*

CO-CHAIRS John Winkelman & Virend Somers

SPEAKERS AND TITLE
John Winkelman
Epidemiologic evidence linking RLS and other sleep disorders to cardiovascular disease
Virend Somers
Neural mechanisms linking RLS and other sleep disorders to cardiovascular disease
Daniel Gottlieb
Vascular mechanisms linking RLS and other sleep disorders to cardiovascular disease
Naresh Punjabi
Inflammatory/metabolic mechanisms linking RLS and other sleep disorders to cardiovascular disease
John Winkelman & Virend Somers
Open discussion on how cardiovascular disease relates to RLS.

SESSION 10 Brain Imaging and Connectivity

CO-CHAIRS Giovanni Rizzo & Yong Won Cho

SPEAKERS AND TITLE
Giovanni Rizzo
Brain MRI in RLS:
1) Iron level to possible structural changes
2) Regional brain metabolic dysfunctions in RLS patients: magnetic resonance spectroscopy findings
Xu Li
Brain iron imaging options, limits  and  relation to RLS biology and clinical features
Sebastiano Galantucci 
Investigating brain connectivity from resting state functional MRI recordings: methodological aspects
Yong Won Cho
Resting state functional MRI assessments in RLS
Giovanni Rizzo & Young Won Cho
Discussion

SESSION 11 New Treatment Implications of Current Science*

CO-CHAIRS Diego Garcia-Borreguero & Sergi Ferre

SPEAKERS AND TITLE
Chris Earley
Iron biology relevance for iron treatment of RLS
Diego Garcia Borreguero
Role of drugs acting on the calcium channels
Mauro Manconi
The future of animal models for drug development of RLS; animal models for rapid screening of RLS
Sergi Ferre
Getting mechanistic with new in vivo models of cortico-striatal neurotransmission
Seema Gulyani
Adenosine, iron and relationship to RLS
Diego Garcia Borreguero
Summary discussion of future treatments with interactive questions and answers

SESSION 12 Clinical Updates

CO-CHAIRS Luigi Ferini-Strambi &  S Chokroverty

SPEAKERS AND TITLE
Marco Zucconi
Summary review of the PLMS task force
Ferini-Strambi & Chokroverty
Discussion of PLMS task force
Mike Silber
Summary review of the treatment algorithm from the augmentation
task force
Ferini-Strambi & Chokroverty
Discussion of treatment algorithm
Bill Ondo
Deep brain stimulation and RLS: Pathophysiology considerations
Ferini-Strambi & Chokroverty
Discussion of DBS and overall summary of clinical updates

 

Contact us for registration, hotel reservations, and sponsorship opportunities:
Administration Office
Attn: Allan O’Bryan
IRLSSG
3270 19th ST NW I Suite 110
Rochester, MN 55901 USA
email: secretary@irlssg.org
website: www.irlssg.org

 

Collaborative Online Valencia-Based Educational Program

Derived from the IRLSSG 2013 Annual Meeting and the 2013 World Congress on Sleep Medicine held in Valencia, Spain, this online program will incorporate recorded lectures, interviews, supportive slides, and videotapes, to provide updates and summaries on current RLS research and the clinical environment.

Click on the image below to access the online educational program.

for irlssg site

 

Long-term treatment guidelines of RLS published in Sleep Medicine (2013)

2016 Annual Meeting

International RLS Study Group Annual Meeting 2016

Location: Denver during APSS SLEEP 2016

Date: Sunday, June 12, 2016

Time: 8:00 AM – 8:30 PM

Place: Denver Athletic Club
             1325 Glenarm Pl
             Denver, CO 80204
             Phone:   303-534-1211

Walking Directions from SLEEP:  Exit convention center on 14th ST.  Take right (south-east) one block on 14TH ST.  Located on corner of Glenarm and 14th ST.

Room: Centennial Room

RSVP at:  http://doodle.com/poll/xkiaxck53sxxreg9

PDF: IRLSSG Symposium Denver 2016 agenda and directions

Presentations on RLS

RLS and iron

08:00-08:20 AM        Effects of iron deficits and iron treatments

                                         Richard Allen            

08:20-08:40 AM       The genetics of iron regulation and its importance for RLS

                                         Byron Jones

 Genetics

 08:40-09:00 AM       From genotype to phenotype in RLS and PLMS

                                         David Rye

09:00-09:30 AM       Dopaminergic systems and cells adhesion molecules: Novel therapeutic targets

                                        George Uhl

 09:30-10:00 AM       Coffee break

 Treatment implications

 10:00-10:20 AM       Quality measures of RLS care

                                         Denise Sharon

10:20-10:40 AM       Role of drugs acting on calcium channels

                                        Diego Garcia-Borreguero

10:40-11:00 AM       Treatment algorithm from the augmentation task force

                                       Mike Silber

11:00-11:20 AM       RLS and Hypoxia

                                       Ambra Stefani

11:20-11:40 AM       Quantitative Sensory Test for RLS

                                      Yong Won Cho        

11:40-12:00              Withdrawal symptoms from dopaminergic compared to non-dopaminergic RLS treatment

                                      Richard Allen

12:00-12:20 PM       Vitamin D deficiency and treatment in Sicilian ambulatory RLS patients

                                      Rosalia Silvestri

12:20-01:20 PM       Lunch

01:30-02:30 PM       Young Investigator award recipients

 RLS and cardiovascular disease

02:30-03:00 PM        Epidemiology linking RLS and CVD

                                         John Winkelman

 Current controversies

03:00-03:30 PM       RLS Augmentation under opioids vs Opioid induced hyperalgesia

Sudhansu Chokroverty and Diego Garcia-Borreguero

 3:30-4:00 PM           Coffee break

 Business Meeting

4:00-5:30 PM           Business Meeting

 Dinner 

 5:30-6:00 PM           Networking, social, and drinks

6:00-8:00 PM           Dinner    (Denver Athletic Club – Denver Room 1)

8:00-8:30 PM           Award recognition and social networking

 Please RSVP (not required but appreciated to confirm lunch and dinner numbers):  http://doodle.com/poll/xkiaxck53sxxreg9

Summary of Recommendations for the Long-Term Treatment of RLS/WED from an IRLSSG Task Force

Summary of Recommendations for the Long-Term Treatment of RLS/WED from an IRLSSG Task Force

Click on the link below to read online or download.

Summary-of-RLS-Treatment-Recommendations.pdf

Wayne Hening Young Investigator Awards

Wayne Hening Young Investigator Awards

Named to honor the memory of a pioneer in RLS research and established in 2010, the Wayne Hening Young Investigator Awards are presented at the annual meeting of the IRLSSG. The $1,000 awards recognize research efforts by new investigators in an attempt to promote interest in the study of RLS.

The Wayne Hening Young Investigator Awards will be made to welcome:

1. Either young investigators new to the RLS/PLMS field who are no more than 10 years past receiving their PhD or MD; or
2. Senior investigators new to the RLS/PLMS field (first publication of a first author abstract or journal article in the RLS/PLMS field is within the last 3 years); and
3. Their scientific RLS/PLMS work was accepted for presentation

The awardees are expected to present their work at the IRLSSG annual meeting.  Abstracts considered for award will be judged based on work quality and relevance to the field.

Award applications should include the following: 1. Name, address, and scientific affiliation 2. Current job and professional role 3. Scientific mentor/senior associate (for junior investigators) 4. Submitted abstract and official indication of acceptance or scientific role of the applicant in the scientific encounter with official documentation attached to the application (this can be submitted later than the initial application if relevant information is unavailable at the first point). 5. Other information supporting the application when appropriate or needed (e.g. comments about relevance of the work to RLS or about role/activity in the IRLSSG meeting.) Applications should be sent by email to: IRLSSG Wayne Hening Award Committee c/o Allan O’Bryan Executive Secretary IRLSSG secretary@irlssg.org

2015 Wayne Hening Young Investigator Award Recipients: 

Laura Triguero: Prospective Study Of Iron Metabolism And Rls In Blood Donors
Aaro Salminen: Prepulse Inhibition And Auditory Startle Response In Meis1 Knock-out Mice

2014 Wayne Hening Young Investigator Award Recipients:

Suzie Bertisch: Cardiovagal Baroreflex Gain is Reduced in Patients with RLS
Thomas Dye: Long Term Treatment Outcomes of Iron Supplementation in Pediatric Restless Leg Syndrome and PLMD
Yong Seo Koo: Efficacy of Transcranial Direct Current Stimulation In Patients With Drug-Naïve Restless Legs Syndrome

2013 Wayne Hening Young Investigator Award Recipients:

Patrizia Congiu:  Neurophysiological evaluation of spinal excitability in patients affected by primitive restless legs syndrome
Amanda Freeman: PTPRD expression regulates sleep consolidation in drosophila
Samantha Kerr:  Reflex testing reveals circadian variation of spinal excitability in restless legs syndrome patients
Marta Moraleda-Cibrian: Restless leg syndrome in young children with orofacial cleft
Aaro Salminen:  Periodic leg movements in spinal cord injury: Evaluation of arousals and treatment effect
Andras Szentkiralyi: Multimorbidity and the risk of restless legs syndrome in two prospective cohort studies
Irina Zavalko: Polysomnographic evaluation of augmentation in patients with restless legs syndrome

2012 Wayne Hening Young Investigator Award Recipients:

Victoria Mery, McGill University, Montreal for High false-positive rate of questionnaire-based RLS diagnosis in MS
AQ Rana, PD Clinic and MD Center, Toronto for Exacerbation of Pain by RLS and PD, A Case Control Study.
Bryndis Benediktsdottiri, Landspitali University Hospital, Iceland for Prevalence of RLS among patients with OSA before and after CPAP treatment compared to the general population
Maryann Deak, Sleep Health Centers, Harvard Medical School, Boston for Correlates of respiratory events with and without associated leg movements in obstructive sleep apnea
Mark Boulos, University of Toronto for Nocturnal Limb Movements are Correlated with Cerebral White Matter Hyperintensities and Fronto-Executive Deficits