You can use regular actimeter to record periodic leg movements but I think I have seen some specific device dedicated to this purpose based on actimeter (or accelerometer) technology. However, the diagnosic of RLS is a clinical one (Cf: the 4 criteria) and recording PLM is only an evaluation of severity and sometimes a tool to monitor treatment efficacy.
Actigaphy is not a tool used in the diagnosis or treatment of restless leg syndrome. However, some advanced level III home sleep test devices such as the NATUS MPR with its ExG channel, can measure limb movements found in periodic limb movement disorder. As Alain Nicholas above said, RLS is a clinical disorder - and apart from checking the ferritin level and making sure it is in the 100-150 mcg/L range, use of the 4 tiers of pharmacological medications including antiparkinson drugs, benzodiazepines such as clonazepam, anticonvulsant agents such as gabapentin, and in extreme cases, opiates such as tramadol are useful treatment adjuncts. I will start by using oral iron to boost the ferritin level first.
As mentioned above, the diagnosis of RLS is a clinical based diagnosis and severity must be evaluated using a validated scale such as IRL rating scale
http://www.medicine.ox.ac.uk/bandolier/booth/RLS/RLSratingscale.pdf
At the moment actigraphy seems to be a useful tool to monitor treatment response and diagnose comorbid circadian rhythm disorders.
Restless legs is a strict clinical syndrome. Acigraphy can show the whole motoric map of the sleep of the RLS. It is a good tool in the follow-up of the treatment of RLS also mirroring the change of the night-sleep structure which might be very important for the treatment of the non-motoric symptoms of RLS.
Actigraphy is a diagnostic tool not a mangement strategy. More over it can not be used in the diagnosis of RLS. It basically measuresvthe movement and based on this movement log it identifies the stages. But in RLS the sleep stages will be recognised as awake state. Therefore it can not be used in diagnosis.
Regards
Dear Imran Khawaja - The treatment of Restleg Legs syndrome (RLS) is interesting. The association with ferritin, both in the blood (and possibly in the brain is intriguing) - it is certainly worth tresting the patient with iron if the ferritin is low, before proceeding in turn to dopa, clonazepam, gabapentin and finally opiates. Actigraphy may be helpful to monitor response to therapy. Cambridge Neurotechnology are a useful source of equipment and advice. You may also be interested in this recewnt paper from Zurich: Cippa et al (2013) Actigraphic assessment of periodic leg movements in patients with restless legs syndrome. J Sleep Res. 2022(5):589-92. doi: 10.1111/jsr.12053. Epub 2013 Mar 26.
Hope this helps
Hello, the literature mentioned above would be useful. However, it would be a fairly straightforward exercise to test to see if the actigraph is picking up the movements and reporting them accurately as counts. You could compare a count of videoed movements with the actigraph counts and see exactly what the actigraph is telling you. We have done similarly in girls and women with Rett syndrome to determine if the actigraph can accurately identify steps. Jenny
Please do not confuse restless legs syndrome with periodic limb movements. RLS is diagnosed solely on history. In children it is helpful to see PLMs on a PSG to suggest a diagnosis of RLS as the history is often unclear from young children.
But wasn't the question in regards to change over time and responsiveness to treatment?
Hello, As already mentioned, RLS is a clinical condition based on satisfaction of 4 criteria:1)urge to move legs, 2) which begins or worsens when sitting or lying down,3) which relieves by movement, and4)urge to move is worse in the evening or night. specificity of this, however, is 84 percent, and positive predictive value 40 percent( Honing et al, 2009, Sleep Med) . other conditions, such as local leg pathology, cramps, etc can mimic RLS., history can help in differential diagnosis.
Once the diagnoses is established,and treatment prescribed, based on the aetiology( primary or secondary), actigraphy may serve in monitoring response to treatment( pre-post comparison), given it cost effectiveness and ability to observe prospectively for prolonged period. However, patient-report outcome measure is of inmost value, as the diagnoses is clinical. Hope this helps.
There are a few studies showing use of actigraphy to diagnose RLS, but I don't know of any studies which are used to monitor treatment.
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