School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
Med Hypotheses. 2010 Jun;74(6):968-72. doi: 10.1016/j.mehy.2009.12.009. Epub 2010 Jan 13.
Chronic pain conditions often "mimic" the symptoms of restless legs syndrome (RLS) with worse pain in the evening and upon rest, associated with an urge to move and relief upon movement. We propose that too little has been made of these parallels, with pain conditions resembling RLS being dismissed as mimics. We found, in a large questionnaire study (n=283) on phantom limb perception, a pattern of phantom pain that resembled RLS: amputees with nocturnal phantom pain were more likely to report worse pain upon rest and/or lying down, with an urge to move the phantom and/or walk to relieve their pain, and to experience spontaneous limb movements akin to periodic leg movements of RLS. We present the hypothesis that a model of restless legs syndrome may provide new insights into the mechanisms underlying phantom pain, and lead to new mechanism-based phantom pain treatment. In particular, central changes associated with sensory and motor symptoms of RLS, neuropathy, and dopamine may also be involved in those predisposed to experience phantom pain that mimics the symptoms of RLS. Ultimately, restless legs syndrome may indeed be a pain syndrome, and warrants further investigation in chronic pain populations.
慢性疼痛病症常与不宁腿综合征（RLS）的症状类似，其在晚上和休息时疼痛加剧，伴有移动的冲动和移动后的缓解。我们认为，这些相似之处还没有得到充分的重视，将类似于 RLS 的疼痛病症视为模仿病症。我们在一项关于幻肢感知的大型问卷调查研究（n=283）中发现，幻肢痛呈现出类似于 RLS 的模式：夜间出现幻肢痛的截肢者在休息和/或躺下时更有可能报告疼痛加剧，有移动幻肢和/或走动以缓解疼痛的冲动，并出现类似于周期性腿部运动的自发肢体运动。我们提出假设，不宁腿综合征的模型可能为理解幻肢痛的潜在机制提供新的见解，并为基于机制的幻肢痛治疗带来新的方法。特别是，与 RLS 的感觉和运动症状、神经病和多巴胺相关的中枢变化也可能与那些易出现类似 RLS 症状的幻肢痛有关。最终，不宁腿综合征可能确实是一种疼痛综合征，值得在慢性疼痛人群中进一步研究。
