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Session Schedule

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0:00:00
Introduction

0:03:05
The therapeutic efficacy of iron supplementation in adults
Claudia Trenkwalder (Germany)

0:26:10
Measuring serum vs brain iron status. The use of SN Ultrasound in RLS
Diego Garcia-Borreguero (Spain)

0:52:30
Iron deficiency and augmentation
Chung-Yao Hsu (Taiwan)

1:14:55
The therapeutic efficacy of iron supplementation in the pediatric population
Gulcin Benbir Senel (Turkey)

1:37:30
Question and answer

Summary

A substantial body of literature suggest that iron deficiency plays a substantial role in the pathophysiology of RLS: On the one hand, systemic iron deficiency (ID) appears to be an important environmental trigger for the worsening or development of RLS, while on the other hand, despite normal peripheral iron stores, RLS patients appear to suffer from brain iron deficiency (BID). In fact, current findings suggest that ID can exist in the certain tissues despite normal blood levels, and suggest a disconnect between serum-determined and CNS-measured iron levels in patients with RLS. Indeed, cellular ID in the Substantia Nigra has been the most consistent finding and at least represents a viable surrogate for an altered iron homeostatic mechanisms in RLS. In fact, animal models based around the construct of low brain iron or BID constitute a valid translational approach towards better treatment options in this disease. Furthermore, attempts to improve or reverse the BID status have led to improvement in RLS symptomatology and represent a viable option to modify not only the severity of the disease but also the response to existing treatments.
The Symposium will present and discuss new data showing the therapeutic efficacy of intravenous iron in adults, leading thereby to a reduction of the required dose of medication and eventually augmenting the therapeutic response to dopaminergic and glutamatergic medication. In addition, new brain imaging data showing regional variation in iron content across different brain regions and their response to treatment with intravenous iron will be presented. Exacerbations of these regional variations in brain iron might also underlie a worsening in the response to RLS treatments, requiring higher doses of the dopaminergic medication and thereby inducing the process of Dopaminergic Augmentation. Finally, the Symposium will show existing data on the use of intravenous iron for the treatment of pediatric RLS.

Learning Objectives:

Upon completion of this CME activity, participants will be able to:
• Discuss the rationale and the efficacy data of studies involving oral and intravenous iron in RLS
• Discuss potential complications of treatment and current guidelines on iron treatment
• Discuss potential predictors of treatment response for IV iron
• Discuss serum iron parameters and their relation to treatment response
• Describe transcranial ultrasound as a novel technique to measure brain iron content
• Discuss current treatment guidelines on iron treatment, in face of the new brain imaging techniques
• Show the rationale and discuss the existing efficacy data of studies involving oral and intravenous iron in augmented RLS
• Discuss potential complications of treatment and current guidelines on iron treatment in augmentation
• Discuss the rationale and the efficacy data of studies involving oral and intravenous iron in pediatric RLS
• Discuss potential complications of treatment in the pediatric population
• Discuss current treatment guidelines on iron treatment in the pediatric population