Brian B. Koo, MD
Associate ProfessorCards
About
Research
Overview
Medical Research Interests
Neurology; Restless Legs Syndrome; Sleep; Sleep Apnea, Obstructive; Stroke; Veterans
Publications
2024
The Melanocortin and Endorphin Neuropeptides in Patients with Restless Legs Syndrome
Koo B, Abdelfattah A, Eysa A, Lu L. The Melanocortin and Endorphin Neuropeptides in Patients with Restless Legs Syndrome. Annals Of Neurology 2024, 95: 688-699. PMID: 38308537, DOI: 10.1002/ana.26876.Peer-Reviewed Original ResearchRestless legs syndromeRestless legs syndrome patientsRestless legs syndrome severityAdrenocorticotropin hormoneCerebrospinal fluidB-endorphinPro-opiomelanocortinA-MSHPlasma adrenocorticotropin hormoneRLS participantsInternational RLS Study Group Severity ScaleRLS patientsAssessed plasmaPain symptomsLumbar punctureA-melanocyte-stimulating hormoneMatched controlsPatientsHormoneSeverity ScaleSensory discomfortPlasmaSeverityMelanocortin hormonesHyperalgesiaAssociation of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality
Zinchuk A, Srivali N, Qin L, Jeon S, Ibrahim A, Sands S, Koo B, Yaggi H. Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality. Journal Of The American Heart Association 2024, 13: e031630. PMID: 38240208, PMCID: PMC11056155, DOI: 10.1161/jaha.123.031630.Peer-Reviewed Original ResearchConceptsPeriodic limb movement indexApnea-hypopnea indexObstructive sleep apneaPeriodic limb movementsSleep apneaIncident cardiovascular diseasePrimary outcomeCardiovascular diseaseAssociation of apnea-hypopnea indexIncreased risk of primary outcomeIncreased riskRisk factorsRisk of primary outcomeAssociated with primary outcomeMedian follow-upBaseline risk of mortalityCox proportional hazards regressionRisk of cardiovascular diseaseLimb movement indexCharlson Comorbidity IndexFramingham risk scoreProportional hazards regressionRisk of mortalityCardiovascular disease eventsFollow-upPatient Insights on Integrating Sleep Apnea Testing into Routine Stroke and TIA Care
Rattray N, Story K, Burrone L, Sexson A, Koo B, Bravata D, Perkins A, Myers L, Daggy J, Taylor S, Fields B, Kunisaki K, Daley J, Palacio S, Hermann L, Sico J. Patient Insights on Integrating Sleep Apnea Testing into Routine Stroke and TIA Care. Journal Of Patient Experience 2024, 11: 23743735241310263. PMID: 39742072, PMCID: PMC11686624, DOI: 10.1177/23743735241310263.Peer-Reviewed Original ResearchObstructive sleep apnea testingObstructive sleep apneaTransient ischemic attackSleep testPrevalence of obstructive sleep apneaPatients expressed higher levelsSleep apnea testingCerebrovascular diseaseGuideline-concordant screeningSleep apneaApnea testingIschemic attackPatientsImprove outcomesAHA/ASA guidelinesIschemic strokeStroke/TIAVeterans Affairs facilitiesAcute stroke/TIARoutine partExperience of careThematic analysis of semi-structured interviewsCerebrovascularAnalysis of semi-structured interviewsDisease
2023
Can tonic motor activation be the magical elixir for restless legs syndrome?
Berkowski J, Koo B. Can tonic motor activation be the magical elixir for restless legs syndrome? Sleep 2023, 46: zsad230. PMID: 37671678, PMCID: PMC11240113, DOI: 10.1093/sleep/zsad230.Peer-Reviewed Original ResearchReview of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome
Walters A, Li Y, Koo B, Ondo W, Weinstock L, Champion D, Afrin L, Karroum E, Bagai K, Spruyt K. Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome. Brain 2023, 147: 26-38. PMID: 37633259, PMCID: PMC10796165, DOI: 10.1093/brain/awad283.Peer-Reviewed Original ResearchConceptsRestless legs syndromeMu-opioid receptorsRLS patientsEndogenous opioidsLegs syndromeOpioid receptorsSerum ironΒ-endorphinMelanocortin systemIdiopathic restless legs syndromeRLS-like symptomsPeriodic limb movementsLow serum ironWild-type miceSensory changesMelanocyte stimulating hormoneReceptor blockersSerum ferritinAutopsy studyStriatal dopamineAdrenocorticotropic hormoneStimulating hormoneDopaminergic systemMouse modelTherapeutic efficacyDifferential impact of resilience on demoralization and depression in Parkinson disease
de Figueiredo J, Zhu B, Patel A, Kohn R, Koo B, Louis E. Differential impact of resilience on demoralization and depression in Parkinson disease. Frontiers In Psychiatry 2023, 14: 1207019. PMID: 37559912, PMCID: PMC10408307, DOI: 10.3389/fpsyt.2023.1207019.Peer-Reviewed Original ResearchDevelopment and validation of a model predicting mild stroke severity on admission using electronic health record data
Waddell K, Myers L, Perkins A, Sico J, Sexson A, Burrone L, Taylor S, Koo B, Daggy J, Bravata D. Development and validation of a model predicting mild stroke severity on admission using electronic health record data. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107255. PMID: 37473533, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107255.Peer-Reviewed Original ResearchConceptsInitial stroke severityStroke severityElectronic health record dataHealth record dataSevere strokeIschemic strokeStroke careSample patientsMortality risk stratificationRecord dataVeterans Affairs hospitalMild stroke severityMultiple logistic regressionObservational cohortStroke outcomeIndependent predictorsRisk stratificationEHR data elementsPrimary analysisLogistic regressionStrokeValidation sampleSeverityPotent modifierEHR dataYou too can increase brain iron to treat restless legs syndrome
Koo B. You too can increase brain iron to treat restless legs syndrome. Sleep 2023, 46: zsad181. PMID: 37419490, DOI: 10.1093/sleep/zsad181.Peer-Reviewed Original ResearchImpact of the coronavirus disease-2019 pandemic on Veterans Health Administration Sleep Services
Sico J, Koo B, Perkins A, Burrone L, Sexson A, Myers L, Taylor S, Yarbrough W, Daggy J, Miech E, Bravata D. Impact of the coronavirus disease-2019 pandemic on Veterans Health Administration Sleep Services. SAGE Open Medicine 2023, 11: 20503121231169388. PMID: 37152838, PMCID: PMC10158800, DOI: 10.1177/20503121231169388.Peer-Reviewed Original ResearchSleep servicesCoronavirus diseaseVeterans AffairsSleep medicine providersHome sleep testingVeterans Affairs facilitiesTransmission precautionsSleep testingVideo telehealthSleep studiesMedicine providersMedicine servicePre-pandemic surveyCare deliveryMedicine personnelClinicDiagnostic studiesDiseaseHigh rateSecond surveyPandemicPandemic periodHigh levelsOnline surveySeparate surveys
2022
Re-equip with opioids instead of dopamine agonists for the treatment of augmentation
Koo B. Re-equip with opioids instead of dopamine agonists for the treatment of augmentation. Sleep 2022, 45: zsac115. PMID: 35556146, DOI: 10.1093/sleep/zsac115.Peer-Reviewed Original Research
Clinical Trials
Current Trials
Intestinal Immunity in Neurologic Disease
HIC ID2000033081RoleSub InvestigatorPrimary Completion Date12/31/2023Recruiting ParticipantsSchizophrenia Spectrum Biomarkers Consortium (SSBC)
HIC ID2000029485RoleSub InvestigatorPrimary Completion Date12/31/2030Recruiting Participants
Academic Achievements & Community Involvement
Clinical Care
Overview
Brian B. Koo, MD, is an award-winning physician who combines his training in neurology and sleep medicine to treat patients with a wide variety of sleep disorders.
An internationally recognized expert in his field, Dr. Koo is the director of the Sleep Medicine Program at the Connecticut Veterans Affairs Healthcare System, as well as director of the Yale Medicine Program for Restless Legs Syndrome (RLS). He works with patients who suffer from sleep disorders, including narcolepsy, RLS, sleep apnea and sleep issues caused by neurological conditions. “Sleep disorders are very treatable and we are almost always able to provide simple, effective treatments that can significantly and positively impact quality of life,” he says.
An assistant professor of neurology at Yale School of Medicine, Dr. Koo is also an active researcher and author specializing in RLS, and one of the world’s foremost experts on the epidemiologic research that links periodic limb movements during sleep and cardiovascular disease.
Clinical Specialties
Neurology
Fact Sheets
Pediatric Movement Disorders
Learn More on Yale MedicineRestless Legs Syndrome (RLS)
Learn More on Yale Medicine
Yale Medicine News
News
News
- March 04, 2025Source: Yale Medicine
Do You Have Restless Legs Syndrome (RLS)? Treatment Advice Has Changed
- July 27, 2023Source: Frontiers in Psychiatry
Differential Impact of Resilience on Demoralization and Depression in Parkinson Disease
- October 19, 2017
Lower brain glucose levels found in people with obesity, type 2 diabetes
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