多巴胺与不安腿综合征中的脊髓：脊髓生理学是否揭示了增敏现象的基础？

Dopamine and the spinal cord in restless legs syndrome: does spinal cord physiology reveal a basis for augmentation?

作者信息

Paulus Walter, Schomburg Eike D

机构信息

Department of Clinical Neurophysiology, University of Göttingen, Robert Koch Str. 40, 37075 Göttingen, Germany.

出版信息

Sleep Med Rev. 2006 Jun;10(3):185-96. doi: 10.1016/j.smrv.2006.01.004.

DOI:10.1016/j.smrv.2006.01.004

PMID:16762808

Abstract

The pathophysiology of restless legs syndrome (RLS) is incompletely understood. L-DOPA, as the precursor of dopamine, as well as dopamine agonists, plays an essential role in the treatment of RLS leading to the assumption of a key role of dopamine function in the pathophysiology of RLS. Periodic limb movements in sleep are a key feature of RLS. They are generated in the spinal cord. Here we review RLS phenomenology on the basis of known dopaminergic influence on spinal control, which has been studied a great deal in recent decades in animals. In particular, we propose that the differential effects of l-DOPA and opioids on early and late flexor reflexes may be linked to the phenomenon of augmentation.

摘要

不安腿综合征（RLS）的病理生理学尚未完全明确。左旋多巴作为多巴胺的前体，以及多巴胺激动剂，在RLS的治疗中发挥着重要作用，这使得人们推测多巴胺功能在RLS的病理生理学中起关键作用。睡眠期周期性肢体运动是RLS的一个关键特征。它们在脊髓中产生。在此，我们基于已知的多巴胺能对脊髓控制的影响来综述RLS的现象学，近几十年来在动物身上对此进行了大量研究。特别是，我们提出左旋多巴和阿片类药物对早期和晚期屈肌反射的不同作用可能与症状加重现象有关。