Mauro Manconi has been selected as the winner of the European Federation of Neurological Associations (EFNA) Award 2022 'Advocating for Gender Equity in Neurology' in the category "Outstanding Achievement by a Medical Professional" for his continuous and outstanding scientific work on the topic of RLS and pregnancy.
The common medical condition you've never heard of (BBC Reel)
'Restless legs syndrome' (RLS) is a condition of the nervous system that, in its most serious form, can be highly debilitating. It is thought to affect roughly 10 percent of people worldwide, so how come it is still relatively unknown and poorly understood?
BBC Reel's Howard Timberlake goes in search of some facts and discovers that the condition, and some of the medication used to treat it, throws up more questions than it does answers.
EARLS Statement in Support of Ukraine
It is with deep concern and enormous sadness that we at EARLS regard the unprecedented military aggression against Ukraine. While EARLS remains an apolitical organisation representing European RLS patient groups, we refute the use violence of any kind in settling disputes.
We appeal for an immediate cessation of hostilities in Ukraine and call for a peaceful resolution. Life in a war zone directly endangers patients, their families and healthcare professionals. Disruption to the safe and effective delivery of treatment and care is an added burden to those affected by neurological conditions.
We plead for peace during this difficult time, and EARLS remains available to facilitate communication and advocate for the health and safety of our members and the patients they serve across Europe.
Katharina Glanz (President) on behalf of all EARLS members
If you are in a position to do so, please consider making a donation to the https://www.ukraine.who.foundation/
New survey on "Assessing the diagnosis and care pathways of people withneurological disorders in Europe"
On the occasion of International Women's Day, the European Federation of Neurological Associations (EFNA) is conducting a survey on "Assessing the diagnosis and care pathways of people with neurological disorders in Europe".
Despite the higher prevalence rate in women than in men of many neurological disorders (e.g. multiple sclerosis, migraine, Alzheimer's disease), gender stereotypes can have a negative impact, leading to under-diagnosis, misdiagnosis and delayed treatment. Furthermore, while women experience neurological disorders differently to men (symptomatic profile, pace of progression and effectiveness of medication), women are often excluded from research.
In addition to the experience of the patient, the majority of informal caregiving roles are occupied by women who are also burdened by the gender divide.
This survey has been developed with the aim of identifying, reporting and beginning to address the varied challenges facing all affected by neurological conditions, either as patients or caregivers, from diagnosis to care pathway. Data generated through this survey can be used to address the unmet needs and challenges facing all affected by neurological conditions.
The survey is open to anyone over the age of 18 who is living with a neurological disorder, or who is carer to someone living with a neurological disorder, that resides in Europe. It is available in 8 languages- English, French, German, Italian, Spanish, Portuguese, Polish and Romanian.
The survey can be accessed at https://www.surveymonkey.com/r/JQW27L2
Deadline for completion of the survey is Tuesday, April 19th.
ICD-11 - Restless Legs Syndrome (RLS) is reclassified
RLS is a marginal phenomenon in the media and unfortunately also in medical perception. This is about to change - as shown by the new ICD-11 disease catalogue.
The International Classification of Diseases (ICD) is a globally recognised system used to give uniform names to medical diagnoses. ICD stands for "International Statistical Classification of Diseases and Related Health Problems".
The ICD is administered by the WHO and used in countries all over the world. Each disease is assigned an ICD code. This is found in patient records, including hospital records, medical charts, visit reports and bills. These codes ensure that patients receive the right treatment and that all medical services are billed correctly. Insurance companies expect the codes to match between a condition and the treatment provided. The codes are used in clinical trials to recruit and track subjects. The ICD is also useful, for example, to facilitate data exchange. ICD codes are also used worldwide to collect health statistics such as morbidity (disease) and mortality (causes of death). This is particularly useful for collecting data on non-communicable diseases.
The 11th version of the International Classification of Diseases 11 (ICD 11) came into force on 1 January 2022. And it is here that we find a significant - one might almost say historic - change for RLS sufferers. In the older versions of the ICD, RLS was still classified under the collective group "Other extrapyramidal diseases and movement disorders". In the new ICD-11, RLS has been given its own code under sleep-related movement disorders: "7A80 - Restless Legs Syndrome".
What does this mean exactly? It means first and foremost that the WHO perceives Restless Legs Syndrome in a much clearer way, giving it a completely new meaning. This is more than just an abstract health policy decision but will result in RLS being perceived much more by doctors and scientists than was previously the case.
Written by Ralf Wenzel, RLS advocacy group Hamburg-Bergedorf (Germany)
EARLS presents burning questions for RLS research, Dec 2021
As part of the annual meeting of the European RLS Study Group (EURLSSG), which was held online in December 2021, the EARLS presented a lecture on "The patient perspective on RLS - some burning questions".
Watch the video here or you can read the full presentation here
2022 - A decisive year for the neurological community
2022 is likely to bring a historic policy change with the potential to impact neurological services worldwide. In May, WHO is expected to adopt its Intersectoral Global Action Plan on epilepsy and other neurological disorders, with the aim “to improve care, recovery, well-being and participation of people living with neurological disorders across the life-course”. With this Global Action Plan, WHO considers neurological disorders, for the first time, as a distinct priority for global health, and the effects of this long-overdue decision should ripple across national health systems and research-funding agendas” https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00001-1/fulltext
Value of Treatment 2 (VOT 2) Synthesis Meeting, 8 June 2021 (13:00-17:00 CET)
The Value of Treatment (VOT) for brain disorders is a health economics and outcomes research project addressing all brain disorders and coordinated by EBC. Brain disorders – both neurological and mental alike – constitute a major factor, alongside cancers and cardiovascular diseases, driving the overall burden of diseases in Europe. Neurological and psychiatric disorders across all lifespans are the leading cause of poor health and disability in Europe. The conclusions of the VOT research project first round released in 2017 (which included case studies on disorders ranging from schizophrenia to Alzheimer’s disease, epilepsy, headache, normal pressure hydrocephalus, Parkinson’s disease, multiple sclerosis, restless legs syndrome and stroke) highlighted the need for more research, early, if possible prodromal, diagnosis and intervention, integrated seamless care underpinning timely care pathways as a solution to address value-based health care in Europe and access to the best treatments available.
Value of Treatment (VOT 2): a second round of case studies
In the continuity of these conclusions and in the framework of the VOT research, a second round of case studies (VOT2) have been developed on new therapeutic areas focusing on rare diseases (Ataxia, Dystonia and Phenylketonuria) and mental disorders (Anorexia Nervosa, Autism Spectrum Disorder, Major Depressive Disorder). The study to be finalised in 2021 is focusing on “early intervention, bridging the gaps and achieving seamless, coordinated care”, and the objective is to examine health gains resulting from optimized healthcare interventions in comparison with current care or no treatment, and converge data evidence to policy recommendations on how to improve the care pathway(s). Previous joint working sessions aimed to exchange and build synergy between the research-work and DG Sante Rare diseases European Reference Networks (ERNs) programme and research as well as the PECUNIA project from the EU Framework on mental health and well-being. Beyond the research design and considering current context, the impact of COVID-19 on treatment and healthcare transformation is also explored.
The European Brain Council (EBC) is pleased to invite you for the Value of Treatment 2 (VOT 2) Synthesis Meeting, to be held virtually on 8 June 2021 (13:00-17:00 CET). Experts participating in the research will present a synthesis of the results so far and examine the most critical issues in brain diseases in Europe from different perspectives including policymakers, innovators, academia and industry, medical professionals and patient organisations.
One voice for neurology Podcast: Living with a neurological disorder
The OneNeurology initiative aims to unite and strengthen neurology-related groups to stimulate collaborative advocacy, action and accountability for the prevention, treatment and management of neurological disorders worldwide.
From advocacy to capacity-building to awareness raising – we want to demonstrate what makes all neurological disorders ONE and what’s in it for the community, and wider society, if they are all addressed together, in parallel to disease specific advocacy activities.
As part of this initiative, a number of podcasts have been produced, one of which is all about people living with neurological disorders. We hear from 3 patient groups from a global, European and national perspective and discuss where the challenges faced are the same and where they differ. As well as exploring how the ONE Neurology Initiative could help address these challenges.
We’ll also hear directly from three people living with different disorders: dystonia, restless legs syndrome and peripheral neuropathy.
The end of Augmentation?
Stefan Clemens, an East Carolina University (ECU) associate professor at the Brody School of Medicine’s Department of Physiology, was awarded a US patent for his novel method of treating restless legs syndrome (RLS), which could lead to more effective care over a longer period of time for patients.
RLS is frequently treated with dopaminergic drugs to replace or prevent the loss of dopamine. While these drugs can deliver a high initial effect, they often lose their effectiveness over time and symptoms can worsen, a side effect known as augmentation. Classic RLS treatments act on a dopamine receptor known as D3, which has a suppressive effect in the nervous system.
Clemens’ animal models show that over time the medication leads to an increase of a different, excitatory receptor subtype, D1. This increase of the D1 receptor might be the cause of augmentation. Clemens’ patent, which he received in late August 2020, targets the increased D1 receptor levels in RLS patients suffering from augmentation, leading to reduced activation of D1 receptors while providing traditional therapy relief from RLS.
“Our lab postulates that this new compound will maintain long-term efficacy for RLS,” Clemens said. “If augmentation begins, we predict that we can reduce D1 receptor activation in patients and balance things back out, keeping the treatment effective.”
Using a grant from the North Carolina Biotechnology Center, Clemens and a collaborator from the University of Houston will run a small pilot study of the new treatment method. His work also gained the attention of a company that has interest in establishing a partnership where ECU’s patent rights may be used in combination with its existing drug formulation for treating augmentation. “The patent would not have been issued without their help,” said Clemens, who is also working on medical treatments for opioid pain tolerance. “I now know that it can be very beneficial to have experts in other areas come from different angles that make us think of other ways to use our work.” Clemens is a member of the Foundation's Scientific and Medical Advisory Board and is the Chair of the Research Grant committee.
Socioeconomic impact of restless legs syndrome and inadequate restless legs syndrome management across European settings
C Trenkwalder 1 2, M Tinelli 3, G K Sakkas 4 5, Y Dauvilliers 6, R Ferri 7, R Rijsman 8, W Oertel 9 10 11, J Jaarsma 10 12 13
European Journal of Neurology, 2021 Feb;28(2):691-706. doi: 10.1111/ene.14582. Epub 2020 Nov 25.
Abstract
Restless legs syndrome (RLS) is one of the most common neurological disorders. It describes an irresistible urge to move the legs, mostly manifested in the evening and at night, which can lead to severe sleep disturbance. As part of the European Brain Council (EBC)-led Value-of-Treatment project, this study aimed at capturing the socioeconomic impact of RLS related to the inadequate diagnosis and treatment across different European healthcare settings. The economic burden of RLS was estimated using the published EBC framework of analysis in three separate European Union healthcare systems (France, Germany, and Italy). The RLS care pathway was mapped to identify the unmet needs of patients. Based on specific patient stories, the economic impact of correctly diagnosing RLS and changing between inadequate and target treatment was calculated using appropriate scenario analysis. RLS proved to be a significant personal and social burden, when epidemiological data, high prevalence of RLS, and its need for treatment are combined. By looking at the savings emerging from the provision of optimal care management (timely and correct diagnosis, evidence-based therapy, avoidance of therapy-related complications such as augmentation), the authors foresee substantial economic savings with the achievement of adequate diagnosis and treatment of RLS. Education about RLS is urgently needed for all subspecialties involved in RLS patient care as well as the general public. Equally important, the search for new causal treatment strategies should be intensified to reduce suffering and substantial societal cost.
In Memoriam: Richard P. Allen, PhD (1938-2020)
December, 2020
It is with great sadness we announce the passing of a grand clinician-scientist in sleep medicine & research: Richard P. Allen, PhD. On December 9, 2020, Dr. Allen passed away peacefully with his wife and children by his side. Dr. Allen dedicated the last 30 years to sleep medicine and in particular for the last 20 years to developing the field of movement disorders in sleep and in particular the Restless Legs Syndrome (RLS) and Periodic Limb Movements of Sleep (PLMS). Dr. Allen’s family ask that memorial donations are made to both the Restless Legs Syndrome Foundation's Allen Fund (RLSF) and International RLS Study Group (IRLSSG).
Dr. Allen was instrumental in building and fortifying RLS research. Drs. Richard Allen and Christopher J. Earley established and co-directed The Johns Hopkins Center for Restless Legs Syndrome, located at the Johns Hopkins Bayview Medical Center. He also served as Chair of the medical advisory board for the Restless Legs Syndrome Foundation and International Restless Legs Syndrome Study Group. Additionally, he was the President of the World Association of Sleep Medicine (now World Sleep Society). Dr. Allen received a bachelors degree in mathematics from the Massachusetts Institute of Technology (MIT) and his doctorate in psychology from the University of Cambridge, Cambridge England. He chaired the NIH-RLSF workshop that produced the current diagnostic standard for RLS and has produced clinical standards for RLS diagnoses and evaluation currently used in most RLS clinical trials. He was also a senior editor of the primary text on Movement Disorders in Sleep and a senior field editor for the major international journal for sleep, Sleep Medicine.
In his over 200 peer-reviewed articles, Dr. Allen was a world-renowned sleep expert on the topics of RLS and periodic limb movements (PLM). His significant contributions to the field earned him the Sleep Research Society Outstanding Sleep and Circadian Scientist Award in 2020. He was instrumental in the field. He will be missed.
