Fulda Stephany, Wetter Thomas C
Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany.
Expert Opin Emerg Drugs. 2005 Aug;10(3):537-52. doi: 10.1517/14728214.10.3.537.
Restless legs syndrome (RLS) is a common, but often underdiagnosed, neurological disorder, which is characterised by an imperative urge to move the extremities associated with paraesthesias, worsening of symptoms at rest and in the evening or at night, and, as a consequence, sleep disturbances. RLS affects 1-10% of the population. The aetiology of RLS is unknown, but besides genetic factors the dopaminergic and opioidergic system may play a crucial role and new developments also point to an exciting iron-dopamine connection in the pathophysiology of this burdening disorder. Due to the limited disease-specific knowledge, current treatment strategies are not curative, but nevertheless may produce an effective and lasting relief of symptoms. Although clinically based treatment has focused on levodopa, opioids and benzodiazepines for a long time, evidence-based and clinical guidelines identify dopamine agonists as a first-line treatment for daily restless legs symptoms. These substances are now in the process of registration for this indication. Ropinirole is the first dopamine agonist that has been approved by the FDA in May 2005. In addition, several promising new therapies with nondopamine profiles are under development for RLS.
不宁腿综合征（RLS）是一种常见但常被漏诊的神经系统疾病，其特征为强烈的肢体活动冲动，伴有感觉异常，休息时以及傍晚或夜间症状加重，进而导致睡眠障碍。RLS影响1%至10%的人群。RLS的病因尚不清楚，但除遗传因素外，多巴胺能和阿片样物质系统可能起关键作用，新的研究进展也表明在这种令人困扰的疾病的病理生理学中，铁与多巴胺之间存在着令人兴奋的联系。由于对该疾病的特定知识有限，目前的治疗策略无法治愈，但仍可有效且持久地缓解症状。尽管长期以来基于临床的治疗主要集中在左旋多巴、阿片类药物和苯二氮䓬类药物上，但循证医学和临床指南将多巴胺激动剂确定为日常不宁腿症状的一线治疗药物。这些药物目前正在进行该适应症的注册。罗匹尼罗是2005年5月被美国食品药品监督管理局（FDA）批准的首个多巴胺激动剂。此外，针对RLS正在研发几种有前景的非多巴胺类新疗法。
