Objective: Primary Restless Legs Syndrome (RLS) is frequently undiagnosed and poorly treated sleep disorder with prevalence 7-10% in general population and 20-30 % in diabetic population, we investigated the prevalence of RLS in type 2 DM and assessed the efficacy of Magnesium therapy.Methods: One hundred patients with diagnosis of type 2 DM without other secondary causes of RLS were screened from data base of regional Narayana diabetic centre of excellence and research institute south India, were screened by essential diagnostic criteria developed by international Restless Legs Study group & severity of RLS and sleep quality were assessed by international Restless Legs Rating scale (IRLS) and Pittsburgh sleeo quality index (PSQI) and patients with moderate – severe neuropathy based on nerve conduction study were excluded from our study. Magnesium dicitrate (600 mg) Co enzyme Q10 (100 mg) & was administered for 12 weeks.Results: RLS was diagnosed in 17 of 100 with mean age 51.6 +/- 11.9, mean duration of diabetes 7.2 +/- 4.1 & mean BMI 27 +/- 4.21. The IRLS score was improved from 12.71 +/- 3.6 to 6.4 +/- 2.1 (p < 0.001) and noticeable change in quality of sleep with change in PSQI dropping from -4.5 (95% CI) to 2.0: P < 0.03) after 12 weeks, however no change in HBA1c parameter or in BMI was noted.Conclusion: We find prevalence of primary RLS in type 2 diabetic patients higher than general population. High BMI is a possible risk factor. Magnesium & Co enzyme Q10 treatment can improve symptoms of RLS and quality of sleep, however long term efficacy in wider diabetic population needs to be to investigated. Objective: Primary Restless Legs Syndrome (RLS) is frequently undiagnosed and poorly treated sleep disorder with prevalence 7-10% in general population and 20-30 % in diabetic population, we investigated the prevalence of RLS in type 2 DM and assessed the efficacy of Magnesium therapy. Methods: One hundred patients with diagnosis of type 2 DM without other secondary causes of RLS were screened from data base of regional Narayana diabetic centre of excellence and research institute south India, were screened by essential diagnostic criteria developed by international Restless Legs Study group & severity of RLS and sleep quality were assessed by international Restless Legs Rating scale (IRLS) and Pittsburgh sleeo quality index (PSQI) and patients with moderate – severe neuropathy based on nerve conduction study were excluded from our study. Magnesium dicitrate (600 mg) Co enzyme Q10 (100 mg) & was administered for 12 weeks. Results: RLS was diagnosed in 17 of 100 with mean age 51.6 +/- 11.9, mean duration of diabetes 7.2 +/- 4.1 & mean BMI 27 +/- 4.21. The IRLS score was improved from 12.71 +/- 3.6 to 6.4 +/- 2.1 (p < 0.001) and noticeable change in quality of sleep with change in PSQI dropping from -4.5 (95% CI) to 2.0: P < 0.03) after 12 weeks, however no change in HBA1c parameter or in BMI was noted. Conclusion: We find prevalence of primary RLS in type 2 diabetic patients higher than general population. High BMI is a possible risk factor. Magnesium & Co enzyme Q10 treatment can improve symptoms of RLS and quality of sleep, however long term efficacy in wider diabetic population needs to be to investigated.

Brain uptake of [(18)F]FDOPA, measured with PET, reflects the activity of aromatic amino acid decarboxylase, an enzyme largely expressed in monoaminergic nerve terminals. This enzyme catalyzes a number of decarboxylation reactions including conversion of l-dopa into dopamine and 5-hydroxytryptophan into serotonin. For more than 20years [(18)F]FDOPA PET has been used to assess dopaminergic nigrostriatal dysfunction in patients with Parkinson's disease (PD). More recently, however, [(18)F]FDOPA PET has also been employed as a marker of serotoninergic and noradrenergic function in PD patients. In this study, we provide further evidence in support of the view that [(18)F]FDOPA PET can be used to evaluate the distribution and the function of serotoninergic systems in the brain. Eighteen patients with PD were investigated with both [(18)F]FDOPA and [(11)C]DASB PET, the latter being a marker of serotonin transport (SERT) availability. We then assessed the relationship between measurements of the two tracers within brain serotoninergic structures. [(18)F]FDOPA uptake in the median raphe nuclei complex of PD patients was significantly correlated with SERT availability in the same structure. Trends towards significant correlations between [(18)F]FDOPA Ki values and [(11)C]DASB binding values were also observed in the hypothalamus and the anterior cingulate cortex, suggesting a serotoninergic contribution to [(18)F]FDOPA uptake in these regions. Conversely, no correlations were found in brain structures with mixed dopaminergic, serotoninergic and noradrenergic innervations, or with predominant dopaminergic innervation. These findings provide evidence that [(18)F]FDOPA PET represents a valid marker of raphe serotoninergic function in PD and supports previous studies where [(18)F]FDOPA PET has been used to assess serotoninergic function in PD.

BACKGROUND:Heterogeneity in clinical presentation and daytime somnolence in restless legs syndrome (RLS) have been poorly explored in the UK.MATERIAL AND METHODS:Analysis of database of 152 cases of primary RLS compiled from clinical consultation using a structured questionnaire administration and clinical examination, spanning six years of referral. Standard evaluations included use of the Epworth Sleepiness Scale (ESS). Secondary RLS was excluded and polysomnography performed in some when clinically indicated.RESULTS:The mean duration of RLS before appropriate treatment initiation was 12.7 years (age range of patients 26-90 years). 79% of patients had insomnia while 30% had excessive daytime sleepiness (EDS). Severe pain, restless arms and paroxysmal RLS causing lifestyle alterations also occurred.CONCLUSIONS:This study suggests that there is considerable delay before appropriate therapy in RLS. A large number have EDS and insomnia among others, is the commonest presenting feature. Phenotypic heterogeneity may cause diagnostic difficulty.