"Restless leg syndrome (RLS), one of the most common and bothering sleeping disorders, is about twice as common in pregnant women than in the overall population, but it seems we now can offer many sufferers a simple and very effective therapy," Prof. Claudio Bassetti today told the Meeting of the European Neurological Society (ENS) in Lisbon. More than 3,200 neurological experts from around the world are currently discussing the latest developments in all areas of their specialty in the Portuguese capital.

Prof. Bassetti of the Neurocentro della Svizzera Italiana in Lugano, reported on preliminary results of an ongoing study showing that infusions of ferric carboxymaltose can significantly reduce the symptoms of RLS in pregnant women with iron deficiency anaemia as early as the first night following treatment.

Disturbing restlessness

In the industrialized countries, restless leg syndrome occurs in 5 to 10 percent of the general population, but in 10 to 20 percent of pregnant women. Its symptoms are tickling, tense, warm, and painful sensations mostly in the legs and increasing at night, resulting in a compulsive urge to move, to strain or to stretch the affected muscles. Common concomitant phenomena are periodic limb movements during sleep and so-called arousals. These are repeated short interruptions of sleep caused by twitches of the muscles, often unnoticed by the patient, but nevertheless amounting to a considerable sleep deficiency at times. Agonising consequences are fatigue, daytime sleepiness, a general decline in performance, and psychiatric symptoms including depression.

Simple iron infusions may return refreshing sleep to the pregnant

"Few studies suggest that pregnant women have a high frequency of RLS and that RLS in pregnancy may be related to iron deficiency", Prof. Bassetti said. "As a consequence, we wanted to study if RLS-symptoms would cease after the iron deficiency was cured. In our ongoing study we are treating child-bearing women, who suffer both from iron deficiency and RLS, with infusions of ferric carboxymaltose, a drug approved in Switzerland for the treatment of iron deficiency anaemia in pregnancy. Ninety percent of the patients so far studied reported a marked decrease in RLS-symptoms starting the first night following treatment. Four weeks after the treatment, the RLS score (a validated tool to assess the severity of RLS symptoms) was reduced from 25 ± 5 to 8 ± 5. We don't expect our final results to significantly diverge from these preliminary data. We conclude that pregnant women with RLS may profit of intravenous iron infusions."

Sleep is a precondition for b! rain recovery after stroke

Another hot topic on the agenda of the ENS Meeting is brain research, especially the increasing understanding of the brain's ability to compensate after damage (neuroplasticity) and the conditions needed for such recovery. "For quite some time already, clinical experience suggests that sleep disturbances may negatively influence the outcome after cerebral stroke, but evidence was missing," reported Prof. Bassetti. "In a new study on a rat model, we were able to prove experimentally, for the first time, that sleep deprivation significantly hampers brain recovery. After inducing an ischemic stroke in a population of rats, one part of the laboratory animals were deprived of 80 percent of their usual sleep during the 12-hours light phase on three consecutive days, whilst another group was allowed to repose as they wanted. Various parameters were assessed such as axonal sprouting, neurogenesis and angiogenesis. On day 14 we already saw significant differences in the healing pr! ogress of both groups. At day 35, less than 50 percent of the brain damages were repaired in the sleep-deprived group, whereas the recovery in the group that was allowed to sleep was almost complete. Further studies are needed to test the hypothesis that sleep enhancing approaches may positively affect recovery after stroke and improve neuroplasticity."

ENS 2011