RLS sub-types???

[AmazedAnt]

I was wondering if anyone has seen or heard of any efforts to categorize RLS into subtypes? With such diverse symptoms , treatment responses, and backgrounds amongst patients - I’ve become curious as to whether someone has looked at the masses of RLS sufferers for patterns that could help distinguish subtypes as well as their preferred treatments 🧐

[Madlegs1]

We can't even get the common garden type sorted.

We'll have no chance with gradations, types, subtypes, crossovers or any "variety you're having yourself" at all, at all.!🤔

But-- thanks for the idea.

We will put it on file!👍

[UsableThought]

Yes, lots of research has been done on subtypes over the years. For example this 2019 study:

sciencedirect.com/science/a...

And even in studies of specific drugs for RLS, there will often be a mention at the start of a study of some of the basic distinctions that are well-known - e.g. as in this old study of Mirapex:

ncbi.nlm.nih.gov/pmc/articl...

Myself, I've known for many years that not everyone experiences pain as part of their baseline RLS. Some do, some don't. I have only experienced pain during episodes of severe augmentation or episodes of withdrawal too quickly from dopaminergic drugs such as Mirapex. I learned that some persons routinely experience pain as part of RLS from a study I once read of dosing for Horizant.

And then there are the distinctions between primary and secondary RLS, the role of heredity, etc. And also the difference between those who also have PLMD (as I do) and those who don't.

I think what researchers are most interested in is a unifying model that can sort out in a definitive sense the interactions of the different physiological mechanisms that cause RLS. So far, to my knowledge, no one has come up with such a model. See for example the opening paragraph in this 2021 "primer" on RLS:

nature.com/articles/s41572-...

Here is an excerpt from that paragraph:

"RLS is considered to be a complex condition in which predisposing genetic factors, environmental factors and comorbidities contribute to the expression of the disorder. RLS occurs alone or with comorbidities, for example, iron deficiency and kidney disease, but also with cardiovascular diseases, diabetes mellitus and neurological, rheumatological and respiratory disorders. The pathophysiology is still unclear, with the involvement of brain iron deficiency, dysfunction in the dopaminergic and nociceptive systems and altered adenosine and glutamatergic pathways as hypotheses being investigated."

So you've asked a good question. . . which hasn't yet been fully answered by medical science.

- Randy

[WideBody]

There are two major classifications that I know of:

Primary RLS: Genetic, hereditary... Probably the hardest to cure.

Secondary RLS: Caused by a deficiency most commonly iron deficiency.

Secondary RLS can be managed if the cause is determined. That is why the first step is to determine iron and Vitamin D levels in any new RLS patients.

I am on of the lucky ones. My RLS was caused by an iron deficiency. Sadly the doctors prescribed DA drugs and not an infusion. I do believe the DA drugs caused permanent damage.