We will perform a study to describe the echogenicity of the substantia nigra, red nucleus and brainstem raphe in PD patients with and without RLS, RLS patients without PD and healthy controls. The echogenicity will be correlated with the the serum…
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
To determine the echogenicity of the substantia nigra, red nucleus and brain
stem raphe in these four groups
Secondary outcome
To determine the serum iron status in these four groups
To determine the relation between echogenicity and iron status in the four
groups
Background summary
Restless Legs syndrome (RLS) and Parkinson*s disease (PD) share possible
pathogenic aspects. The most important aspect is that the two disorders can be
treated with dopamine medication although PD shows neurodegeneration of the
neuromelanine cells in the substantia nigra (SN) which is not found in RLS.
In the two clinical very different disorders also other distinct aspects are
found.
In sonography studies, the substantia nigra (SN) is found to be
hyperechogenitic in PD patients and hypoechogenetic in RLS patients.Animal and
postmortem studies provided evidence that the hyperechogenicity of the SN in PD
patients is related to increased iron levels of the SN. The exact cause of the
iron accumulation in the SN in PD patients is unknown and it is also unknown
whether the iron accumulation in PD is a primary or secondary phenomenon.
As significant lower iron concentrations are found in neuropathological studies
and magnectic resonance imaging in the SN of RLS patients the hypoechogenicity
of the SN in RLS patients is hypothesised to be the result of iron deficiency
in the SN of RLS patients. Several studies showed that iron deficiency in RLS
patients appear to produce a dopamine dysfunction that may involve disruption
of synaptic function resulting in impairing the circadian regulation of
dopamine in RLS patients.
Recently it is shown that PD patients with RLS have lower serum ferritine
levels compared to PD patients without RLS. Sonography studies in RLS
patients also showed a hyperechogenicity of the nucleus ruber (NR) and
hypo-echogenicity of the Brain raphe (BR) compared to healthy controls.
Study objective
We will perform a study to describe the echogenicity of the substantia nigra,
red nucleus and brainstem raphe in PD patients with and without RLS, RLS
patients without PD and healthy controls. The echogenicity will be correlated
with the the serum iron status of the study population to investigate if there
is an association between the iron-status, especially the ferritin levels, and
the echogenicity of the substantia nigra.
Study design
This cross-sectional study is part of an ongoing longitudinal cohort study, the
PROfiling PARKinson*s disease (PROPARK) study.
Study burden and risks
Since the TCS is a non-invasive technique there are no risks for the subjects.
There is a risk factor to develop a haematoma when performing a blood tap.
There is some burden, especially for the PD patients, to make the trip to the
hospital.
lijnbaan 32
2501 CK Den Haag
Nederland
lijnbaan 32
2501 CK Den Haag
Nederland
Listed location countries
Age
Inclusion criteria
Inclusion criteria PD patients with RLS
1.Fulfillment of the United Kingdom PD Society Brain Bank criteria for idiopathic PD.
2.Definite RLS in which all four revised minimal criteria of RLS are fulfilled based on an personal history taken by a RLS trained investigator/ doctor;Inclusion criteria PD without RLS
1.Fulfillment of the United Kingdom PD Society Brain Bank criteria for idiopathic PD.
2.Definite no diagnosis of RLS based on a personal history taken by a RLS trained investigator/ doctor
3.Age, sex , PD severity (Hoehn & Yahr and total levodopa-equivalent) matched to the PD patients with RLS;Inclusion criteria of RLS without PD
1.Definite RLS in which all four revised minimal criteria of RLS are fulfilled based on an personal history taken by a RLS trained investigator/ doctor
2.All secondary RLS patients are excluded besides iron deficiency related RLs
3.Age and sex matched to the PD patients;Inclusion criteria healthy controls
1. Definite no RLS or other known diseases
2. Age and sex matched to the RLS patients without PD
Exclusion criteria
1.No temporal bone window to perform a qualitatively good transcranial sonography
2.Iron medication
3.Pregnancy
Design
Recruitment
metc-ldd@lumc.nl
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL24129.098.08 |