Comorbidities, treatment, and pathophysiology in restless legs syndrome

被引:160
|
作者
Trenkwalder, Claudia [1 ,2 ]
Allen, Richard [3 ,4 ]
Hoegl, Birgit [5 ]
Clemens, Stefan [6 ]
Patton, Stephanie [7 ]
Schormair, Barbara [8 ]
Winkelmann, Juliane [8 ,9 ,10 ]
机构
[1] Univ Med Ctr, Dept Neurosurg, Gottingen, Germany
[2] Paracelsus Elena Hosp, Kassel, Germany
[3] Johns Hopkins Bayview Med Ctr, Sleep Disorders Ctr, Baltimore, MD USA
[4] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA
[5] Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria
[6] East Carolina Univ, Brody Sch Med, Dept Physiol, Greenville, NC 27858 USA
[7] Penn State Hershey Med Ctr, Dept Neurosurg, Hershey, PA USA
[8] Helmholtz Zentrum Munchen, Inst Neurogen, Munich, Germany
[9] Tech Univ, Inst Human Genet, Munich, Germany
[10] Munich Cluster Syst Neurol SyNergy, Munich, Germany
来源
LANCET NEUROLOGY | 2018年 / 17卷 / 11期
关键词
GENOME-WIDE ASSOCIATION; PERIODIC LIMB MOVEMENTS; GENETIC RISK-FACTOR; IRON-DEFICIENCY; EKBOM DISEASE; PARKINSONS-DISEASE; TASK-FORCE; DIAGNOSTIC-CRITERIA; SLEEP DISTURBANCE; INTRAVENOUS IRON;
D O I
10.1016/S1474-4422(18)30311-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Restless legs syndrome, also known as Willis-Ekbom disease, is a common neurological condition whose manifestation is affected by complex environmental and genetic interactions. Restless legs syndrome can occur on its own, mostly at a young age, or with comorbidities such as cardiovascular disease, diabetes, and arterial hypertension, making it a difficult condition to properly diagnose. However, the concept of restless legs syndrome as being two entities, primary or secondary to another condition, has been challenged with genetic data providing further insight into the pathophysiology of the condition. Although dopaminergic treatment was formerly the first-line therapy, prolonged use can result in a serious worsening of symptoms known as augmentation. Clinical studies on pregabalin, gabapentin enacarbil, oxycodone-naloxone, and iron preparations have provided new treatment options, but most patients still report inadequate long-term management of symptoms. Studies of the hypoxic pathway activation and iron deficiency have provided valuable information about the pathophysiology of restless legs syndrome that should now be translated into new, more effective treatments for restless legs syndrome.
引用
收藏
页码:994 / 1005
页数:12
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