Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, Madrid, Spain.
Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, Madrid, Spain.
Sleep Med Rev. 2019 Jun;45:70-87. doi: 10.1016/j.smrv.2019.03.006. Epub 2019 Mar 21.
The most important traditional hypotheses of the pathogenesis of idiopathic restless legs syndrome (iRLS) involve dopaminergic dysfunction and iron deficiency. However, a possible role of other neurotransmitter or neuromodulators, mainly glutamate, gamma-hydroxybutyric acid (GABA), and adenosine have been suggested in recent reports. Moreover, iron deficiency in experimental models (which causes sensorimotor symptoms resembling those of RLS) is able to induce changes in dopaminergic, glutamatergic and adenosinergic neurotransmission, thus suggesting its crucial role in the pathogenesis of this disease. Relationship between iRLS and opiates, oxidative stress and nitric oxide, and with vitamin D deficiency has also been reported, although data regarding these variables should be considered as preliminary. In this review, we focus on studies relating to neurochemical findings in iRLS.
特发性不安腿综合征(iRLS)发病机制的最重要传统假说涉及多巴胺能功能障碍和铁缺乏。然而,最近的报告表明,其他神经递质或神经调质(主要是谷氨酸、γ-羟丁酸(GABA)和腺苷)可能起作用。此外,实验模型中的铁缺乏(引起类似于 RLS 的感觉运动症状)能够诱导多巴胺能、谷氨酸能和腺苷能神经传递的变化,从而表明其在该疾病发病机制中的关键作用。iRLS 与阿片类药物、氧化应激和一氧化氮以及与维生素 D 缺乏的关系也有报道,尽管关于这些变量的数据应被视为初步的。在这篇综述中,我们重点介绍与 iRLS 的神经化学发现相关的研究。