Treating Leg Symptoms in Woman with X-ALD

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• Phase 1: 1. Women
• Phase 1: 2. Ability to provide verbal consent
• Phase 1: 3. A willingness and ability to comply with study procedures
• Phase 1: 4. Age ≥18
• Phase 1: 5. Metabolically or genetically confirmed diagnosis of ALD
• Phase 2: 1. Participation in Phase 1
• Phase 2: 2. Ability to provide written informed consent
• Phase 2: 3. Women with ALD who have Restless Leg Syndrome (IRLS > 15)
• Phase 2: 4. Use of adequate contraception

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• Phase 2: 2. Participants with active or unstable major psychiatric disorder other than ALD, who, in the investigators’ judgement, require further treatment
• Phase 2: 4. Alcohol use disorder within the last 30 days
• Phase 2: 6. Neurological disorder or cardiovascular disease raising safety concerns about use of pramipexole and/or judged to interfere with ability to assess efficacy of the treatment
• Phase 2: 8. Renal disease judged to interfere with drug metabolism and excretion
• Phase 1: 1. Inflammatory brain demyelination
• Phase 2: 9. Patients who are deemed poor candidates by PI discretion
• Phase 2: 1. Pregnant. Research staff perform pregnancy tests upon visit to center
• Phase 2: 3. Use of dopaminergic agonists or antagonists within the last 30 days
• Phase 2: 5. Methamphetamine or benzodiazepine dependence in the last 30 days
• Phase 2: 7. Medical instability considered to interfere with study procedures