Restless legs syndrome mulled as a diagnostic biomarker for multiple conditions

Clinicians have long viewed restless legs syndrome as a condition in and of itself that warrants treatment. But a Boston neurologist theorizes that it is actually a biomarker for various kinds of diseases.

Dr. Sanford Auerbach of Boston Medical Center makes his argument in a March 5, 2014, editorial in the journal Neurology. His conclusion comes in response to an analysis of 12,556 men followed over time by the Health Professionals Follow-up Study, published in the same journal edition (it also makes similar connections).

In a statement issued to promote the editorial, Auerbach, also an associate professor of neurology and psychiatry at the Boston University School of Medicine, said that patients with restless legs syndrome (RLS) consistently had a higher rate and likelihood of a whole slew of problems.

"Patients with RLS had a higher mortality rate than similar men, and showed an especially strong tendency toward cardiovascular disease and hypertension," Auerbach said in a statement. He added that an earlier analysis of the same data showed that restless legs syndrome patients often also were more likely to experience immune system problems, have nutrition-related diseases and get diagnosed for things such as endocrine disease and lung disease.

It's too early for primary care providers to use restless legs syndrome a biomarker tool for their daily diagnosis work. But the connections are promising enough that additional research is probably warranted. Auerbach said as much in an email response to FierceDiagnostics.

"The immediate step is to pursue education of the public and the medical profession," he said. "Patients who may suffer from RLS may not always think to bring these symptoms to the attention of their physician. Also, they may not describe the associated discomfort of RLS in terms that would allow for a simple diagnosis. For instance, a patient today complained of shaking knees. It took some time for her to acknowledge that this was actually a sensation and that it was associated with an urge to move, etc.

"Similarly," he said, "physicians need to be alert to the symptoms and the varied ways in which patients describe these subjective sensations. Physicians then need to consider that this may reflect a risk for other developing medical conditions."

Auerbach told FierceDiagnostics that the long-term "next step" would be to pursue further research, such as an exploration of "the pathophysiology that links RLS to these other physical conditions."

Such a switch would be a major change of thinking regarding RLS, which Big Pharma has long targeted as a condition to treat. Patients who suffer from it experience uncomfortable sensations in their legs and deal with an overpowering urge to move them, usually at night. Sometimes, the condition kicks in just when the sufferer is resting. And now, it is becoming clear to some that there is more than meets the eye when the condition erupts.

- read the release
- here's a journal excerpt

Editor's note: This story has been updated to include additional comments to FierceDiagnostics from lead researcher Sanford Auerbach.

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