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Brian B. Koo, MD

Associate Professor; Director, Sleep Medicine Laboratory at Connecticut Veterans Affairs Healthcare System, Medicine; Director, Yale Center for Restless Legs Syndrome

Contact Information

Brian B. Koo, MD

Mailing Address

  • Neurology

    PO Box 208018

    New Haven, CT 06520-8018

    United States

Yale Medicine

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Research Summary

My main research interests lie in the intersection between neurology and sleep medicine. My current area of focus is on the pathophysiology of restless legs syndrome (RLS) and the role of autoimmunity in REM sleep behavior disorder (RBD). Our lab focuses on the study of humans with neurologically-based sleep disorders to gain knowledge about disease with a focus on assessing disease biomarkers in blood and cerebrospinal fluid. We are particularly interested in the role of the melanocortin hormones in the pathophysiology of RLS. These hormones include alpha-melanocyte stimulating hormone, pro-opiomelanocortin, and beta-endorphin. The latter peptide is the body’s endogenous opioid hormone, which is interesting as opioid medications are very effective in treating RLS. We are also investigating the role of autoimmunity in REM Sleep Behavior Disorder and the onset of Parkinson disease.

Specialized Terms: Restless Legs Syndrome; Periodic Limb Movements During Sleep; Obstructive Sleep Apnea and Stroke

Coauthors

Research Interests

Neurology; Restless Legs Syndrome; Sleep; Veterans; Sleep Apnea, Obstructive; Stroke

Selected Publications

  • Hypothyroidism in restless legs syndrome.Ahmed N, Kandil M, Elfil M, Jamal A, Koo BB. Hypothyroidism in restless legs syndrome. Journal Of Sleep Research 2021, 30: e13091. PMID: 32483857, DOI: 10.1111/jsr.13091.
  • The Management of Restless Legs Syndrome: An Updated Algorithm.Silber MH, Buchfuhrer MJ, Earley CJ, Koo BB, Manconi M, Winkelman JW. The Management of Restless Legs Syndrome: An Updated Algorithm. Mayo Clinic Proceedings 2021, 96: 1921-1937. PMID: 34218864, DOI: 10.1016/j.mayocp.2020.12.026.
  • Implications of the Gut Microbiome in Parkinson's Disease.Elfil M, Kamel S, Kandil M, Koo BB, Schaefer SM. Implications of the Gut Microbiome in Parkinson's Disease. Movement Disorders : Official Journal Of The Movement Disorder Society 2020, 35: 921-933. PMID: 32092186, DOI: 10.1002/mds.28004.
  • Suicidal thought and behavior in individuals with restless legs syndrome.Para KS, Chow CA, Nalamada K, Kakade VM, Chilakamarri P, Louis ED, Koo BB. Suicidal thought and behavior in individuals with restless legs syndrome. Sleep Medicine 2019, 54: 1-7. PMID: 30529070, DOI: 10.1016/j.sleep.2018.09.019.
  • Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea.Zinchuk AV, Jeon S, Koo BB, Yan X, Bravata DM, Qin L, Selim BJ, Strohl KP, Redeker NS, Concato J, Yaggi HK. Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea. Thorax 2018, 73: 472-480. PMID: 28935698, PMCID: PMC6693344, DOI: 10.1136/thoraxjnl-2017-210431.
  • Demoralization in Parkinson disease.Koo BB, Chow CA, Shah DR, Khan FH, Steinberg B, Derlein D, Nalamada K, Para KS, Kakade VM, Patel AS, de Figueiredo JM, Louis ED. Demoralization in Parkinson disease. Neurology 2018, 90: e1613-e1617. PMID: 29618626, PMCID: PMC5931805, DOI: 10.1212/WNL.0000000000005425.
  • Restless legs syndrome and periodic limb movements during sleep in the Multi-Ethnic Study of Atherosclerosis.Doan TT, Koo BB, Ogilvie RP, Redline S, Lutsey PL. Restless legs syndrome and periodic limb movements during sleep in the Multi-Ethnic Study of Atherosclerosis. Sleep 2018, 41 PMID: 29860522, PMCID: PMC6093310, DOI: 10.1093/sleep/zsy106.
  • Periodic leg movements during sleep: phenotype, neurophysiology, and clinical significance.Ferri R, Koo BB, Picchietti DL, Fulda S. Periodic leg movements during sleep: phenotype, neurophysiology, and clinical significance. Sleep Medicine 2017, 31: 29-38. PMID: 28341521, DOI: 10.1016/j.sleep.2016.05.014.
  • Restless Legs Syndrome and Depression: Effect Mediation by Disturbed Sleep and Periodic Limb Movements.Koo BB, Blackwell T, Lee HB, Stone KL, Louis ED, Redline S. Restless Legs Syndrome and Depression: Effect Mediation by Disturbed Sleep and Periodic Limb Movements. The American Journal Of Geriatric Psychiatry : Official Journal Of The American Association For Geriatric Psychiatry 2016, 24: 1105-1116. PMID: 27526989, PMCID: PMC5241001, DOI: 10.1016/j.jagp.2016.04.003.
  • Restless Legs Syndrome: Current Concepts about Disease Pathophysiology.Koo BB, Bagai K, Walters AS. Restless Legs Syndrome: Current Concepts about Disease Pathophysiology. Tremor And Other Hyperkinetic Movements (New York, N.Y.) 2016, 6: 401. PMID: 27536462, PMCID: PMC4961894, DOI: 10.7916/D83J3D2G.
  • Observational Study of Obstructive Sleep Apnea in Wake-Up Stroke: The SLEEP TIGHT Study.Koo BB, Bravata DM, Tobias LA, Mackey JS, Miech EJ, Matthias MS, Stahl SM, Sico JJ, Vaz Fragoso CA, Williams LS, Lampert R, Qin L, Yaggi HK. Observational Study of Obstructive Sleep Apnea in Wake-Up Stroke: The SLEEP TIGHT Study. Cerebrovascular Diseases (Basel, Switzerland) 2016, 41: 233-41. PMID: 26811929, DOI: 10.1159/000440736.
  • The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study: design, rationale, and methods.Koo BB, Won C, Selim BJ, Qin L, Jeon S, Redeker NS, Bravata DM, Strohl KP, Concato J, Zinchuk AV, Yaggi HK. The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study: design, rationale, and methods. Sleep & Breathing = Schlaf & Atmung 2016, 20: 893-900. PMID: 26642771, DOI: 10.1007/s11325-015-1254-3.
  • The Association between Nocturnal Cardiac Arrhythmias and Sleep-Disordered Breathing: The DREAM Study.Selim BJ, Koo BB, Qin L, Jeon S, Won C, Redeker NS, Lampert RJ, Concato JP, Bravata DM, Ferguson J, Strohl K, Bennett A, Zinchuk A, Yaggi HK. The Association between Nocturnal Cardiac Arrhythmias and Sleep-Disordered Breathing: The DREAM Study. Journal Of Clinical Sleep Medicine : JCSM : Official Publication Of The American Academy Of Sleep Medicine 2016, 12: 829-37. PMID: 26951420, PMCID: PMC4877315, DOI: 10.5664/jcsm.5880.
  • Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis.Koo BB, Sillau S, Dean DA, Lutsey PL, Redline S. Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis. Hypertension 2015, 65: 70-7. PMID: 25287399, PMCID: PMC4268086, DOI: 10.1161/HYPERTENSIONAHA.114.04193.
  • Quality measures for the care of adult patients with restless legs syndrome.Trotti LM, Goldstein CA, Harrod CG, Koo BB, Sharon D, Zak R, Chervin RD. Quality measures for the care of adult patients with restless legs syndrome. Journal Of Clinical Sleep Medicine : JCSM : Official Publication Of The American Academy Of Sleep Medicine 2015, 11: 293-310. PMID: 25700882, PMCID: PMC4346652, DOI: 10.5664/jcsm.4550.
  • Characteristics of wake-up stroke.Tanimoto A, Mehndiratta P, Koo BB. Characteristics of wake-up stroke. Journal Of Stroke And Cerebrovascular Diseases : The Official Journal Of National Stroke Association 2014, 23: 1296-9. PMID: 24361192, DOI: 10.1016/j.jstrokecerebrovasdis.2013.10.021.
  • Incidence of restless legs syndrome and its correlates.Budhiraja P, Budhiraja R, Goodwin JL, Allen RP, Newman AB, Koo BB, Quan SF. Incidence of restless legs syndrome and its correlates. Journal Of Clinical Sleep Medicine : JCSM : Official Publication Of The American Academy Of Sleep Medicine 2012, 8: 119-24. PMID: 22505854, PMCID: PMC3311406, DOI: 10.5664/jcsm.1756.
  • Restless legs syndrome: relationship between prevalence and latitude.Koo BB. Restless legs syndrome: relationship between prevalence and latitude. Sleep & Breathing = Schlaf & Atmung 2012, 16: 1237-45. PMID: 22210354, DOI: 10.1007/s11325-011-0640-8.
  • Association of incident cardiovascular disease with periodic limb movements during sleep in older men: outcomes of sleep disorders in older men (MrOS) study.Koo BB, Blackwell T, Ancoli-Israel S, Stone KL, Stefanick ML, Redline S. Association of incident cardiovascular disease with periodic limb movements during sleep in older men: outcomes of sleep disorders in older men (MrOS) study. Circulation 2011, 124: 1223-31. PMID: 21859975, PMCID: PMC3265562, DOI: 10.1161/CIRCULATIONAHA.111.038968.
  • Ventilatory patterning in a mouse model of stroke.Koo BB, Strohl KP, Gillombardo CB, Jacono FJ. Ventilatory patterning in a mouse model of stroke. Respiratory Physiology & Neurobiology 2010, 172: 129-35. PMID: 20472101, PMCID: PMC3698953, DOI: 10.1016/j.resp.2010.05.008.
  • Alpha-melanocyte stimulating hormone and adrenocorticotropic hormone: an alternative approach when thinking about restless legs syndrome?Koo BB, Feng P, Dostal J, Strohl KP. Alpha-melanocyte stimulating hormone and adrenocorticotropic hormone: an alternative approach when thinking about restless legs syndrome? Movement Disorders : Official Journal Of The Movement Disorder Society 2008, 23: 1234-42. PMID: 18464280, PMCID: PMC7350876, DOI: 10.1002/mds.22035.
  • Rapid eye movement-related sleep-disordered breathing: influence of age and gender.Koo BB, Patel SR, Strohl K, Hoffstein V. Rapid eye movement-related sleep-disordered breathing: influence of age and gender. Chest 2008, 134: 1156-1161. PMID: 18812455, PMCID: PMC7448537, DOI: 10.1378/chest.08-1311.

Clinical Trials

ConditionsStudy Title
Diseases of the Nervous SystemRestless Legs Syndrome: The Role of Melanocortin Hormones
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