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揭开不宁腿综合征之谜。

Unraveling the Mysteries of Restless Leg Syndrome.

作者信息

Memon Mohammad D, Faiz Sadaf, Zaveri Mitul P, Perry Jamal C, Schuetz Tayná M, Cancarevic Ivan

机构信息

Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2020 Oct 14;12(10):e10951. doi: 10.7759/cureus.10951.

Abstract

Restless leg syndrome (RLS) or Willis-Ekbom disease (WED) is an under-diagnosed, chronic, and progressive primary sensory-motor disorder. It is characterized by an uncontrollable urge to move the legs due to uncomfortable and sometimes painful sensations, with a diurnal variation. RLS can lead to severe sleep disturbances, a usual cause of consultation. The pathophysiology is known partially, and it is believed that there is an association between the different variants of genetic mutations combined with dopaminergic and brain iron dysregulation, which plays an important role. The data used for this study were extracted from the articles found in the PubMed database that discuss different gene variants, pathophysiology, and various methods of treatment. They also highlight the role of iron in the pathogenesis of RLS as it is required for the synthesis of tyrosine hydroxylase, which is the rate-limiting step for dopamine synthesis. This review article provides a clinically useful overview of RLS in terms of pathophysiological findings, its genetic associations, and therapeutic options by using the currently available literature. Because RLS presents with vague symptoms and shares similarities with many other diseases, it might be overlooked by many physicians resulting in underdiagnosis and under-treatment. While these discoveries provide a breakthrough in understanding the details of RLS, further studies are recommended as these studies are limited to animal models and provide a limited representation of the general population.

摘要

不宁腿综合征(RLS)或威利斯-埃克博姆病(WED)是一种诊断不足的慢性进行性原发性感觉运动障碍。其特征是由于不适甚至有时是疼痛的感觉而产生无法控制的腿部活动冲动,且有昼夜变化。RLS可导致严重的睡眠障碍,这是患者就诊的常见原因。其病理生理学部分已知,人们认为基因突变的不同变体与多巴胺能及脑铁调节异常之间存在关联,这起着重要作用。本研究使用的数据来自于在PubMed数据库中找到的讨论不同基因变体、病理生理学及各种治疗方法的文章。这些文章还强调了铁在RLS发病机制中的作用,因为它是酪氨酸羟化酶合成所必需的,而酪氨酸羟化酶的合成是多巴胺合成的限速步骤。这篇综述文章利用现有文献,就病理生理学发现、其遗传关联及治疗选择,对RLS进行了具有临床实用价值的概述。由于RLS症状模糊且与许多其他疾病有相似之处,许多医生可能会忽视它,导致诊断不足和治疗不足。虽然这些发现为理解RLS的细节带来了突破,但由于这些研究仅限于动物模型且对一般人群的代表性有限,因此建议进一步开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7078/7567326/54bfb79402f0/cureus-0012-00000010951-i01.jpg

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