Integrative Neurobiology Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Triad Building, 333 Cassell Drive, Baltimore, MD 21224, USA.
Integrative Neurobiology Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Triad Building, 333 Cassell Drive, Baltimore, MD 21224, USA.
Sleep Med Clin. 2021 Jun;16(2):249-267. doi: 10.1016/j.jsmc.2021.02.012. Epub 2021 Apr 10.
Akathisia is an urgent need to move that is associated with treatment with dopamine receptor blocking agents (DRBAs) and with restless legs syndrome (RLS). The pathogenetic mechanism of akathisia has not been resolved. This article proposes that it involves an increased presynaptic dopaminergic transmission in the ventral striatum and concomitant strong activation of postsynaptic dopamine D receptors, which form complexes (heteromers) with dopamine D and adenosine A receptors. It also proposes that in DRBA-induced akathisia, increased dopamine release depends on inactivation of autoreceptors, whereas in RLS it depends on a brain iron deficiency-induced down-regulation of striatal presynaptic A receptors.
静坐不能是一种急迫的运动需求，与多巴胺受体阻断剂（DRBAs）的治疗以及不宁腿综合征（RLS）有关。静坐不能的发病机制尚未解决。本文提出，它涉及腹侧纹状体中多巴胺能突触前传递的增加，以及随后的多巴胺 D 受体的强烈激活，这些受体与多巴胺 D 和腺苷 A 受体形成复合物（异源二聚体）。它还提出，在 DRBA 诱导的静坐不能中，多巴胺的释放增加依赖于自身受体的失活，而在 RLS 中，它依赖于脑铁缺乏诱导的纹状体突触前 A 受体的下调。
