Practice
In the New Jersey Neuroscience Institute's Sleep and Movement
Disorders Laboratory, we are investigating the nexus at which movement
disorders and sleep disorders intersect, with a primary focus on the Restless
Legs Syndrome (RLS). This is a sensorimotor disorder that is most bothersome
in middle to older age individuals, but does in fact occur at all ages.
RLS may have a severe impact on waking functioning and a profound impact
upon sleep. Patients with RLS have leg discomfort that makes them sleeplessly
walk the floor at night. When they attempt to lie down they may also have
involuntary twitching movements of the legs and when they go to sleep
the twitching movements of the legs continue as Periodic Limb Movements
in Sleep PLMS). The sleep disruption results in lost job productivity,
impaired social relationships, marital discord and, as we have discovered,
symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in affected
children. Severe RLS may also be misdiagnosed in childhood as "growing
pains".
With the International Restless Legs Syndrome Study Group
(IRLSSG) we have attempted to better define the condition and we have
validated a simple rating scale to determine the severity of symptoms.
This rating scale has now been adapted as a system whereby clinicians
and researchers throughout the world can compare their findings and the
efficacy of the various forms of therapy that are used to treat RLS. Other
research in our laboratory has focused on the circadian rhythmicity of
RLS, its underlying neuroanatomy and its relationship to central dopaminergic
systems, as indicated by the application of Positron Emission Tomography
(PET), analysis of familial patterns of RLS, and new forms of treatment.
Current active research projects include examination of the dopaminergic
responsiveness of ADHD
symptoms in children with and without RLSPLMS, a polysomnographic study
that examines the possibility of an association between PLMS and"growing
pains" in children, a survey and polysomnographic study to determine
if PLMS are disruptive to the sleep of the spouse, and a recently completed
study that suggests that Parkinson's Disease is more common in patients
with RLS.
In 1992, I organized the first medical advisory board
for the
Restless Legs Syndrome foundation (RLSF), a nationwide patient based support
group organization. I served as the first chair of this board and remain
a member. The RLSF has played a key role in educating both the public
and physicians about RLS.
We also run a "Sleep School" every Thursday
from 4-7 pm at the JFK Medical Center New Jersey Neuroscience Institute
for everyone interested in preparing for the American Board of Sleep Medicine
examination -- free of charge. I have been a scorer for part II of the
examination 2001-2002. Prior to this I lectured at the annual American
Academy of Sleep Medicine course 1993-1998.
Currently, we are conducting a Sleep Fellowship Program at the New Jersey Neuroscience Institute, in which two fellows per year see sleep disordered patients in the clinic, read polysomnographic studies, and do research.