하지불안증후군이 중추신경계 질환임을 시사하는 임상적, 신경영상학적, 신경생리학적 증거들에 관하여
What Is the Origin of Restless Legs Syndrome: Central or Peripheral Nervous system? Clinical, Neuroimaging and Neurophysiologic Evidences of Restless Legs Syndrome as a Disorder of Central Nervous System
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Restless legs syndrome (RLS) is a sensorimotor neurological disorder in which the primary symptom is a compelling urge to move the legs, accompanied by unpleasant and disturbing sensations in the legs. Although pathophysiologic mechanism of RLS is still unclear, several evidences suggest that RLS is related to dysfunction in central nervous system involving brain and spinal cord. 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. Patients with RLS have lower levels of dopamine in the substantia nigra and respond to iron administration. Iron, as a cofactor in dopamine production, plays a central role in the etiology of RLS. Functional neuroimaging studies using PET and SPECT support a central striatal D2 receptor abnormality in the pathophysiology of RLS. Functional MRI suggested a central generator of periodic limb movements during sleep (PLMs) in RLS. However, to date, we have no direct evidence of pathogenic mechanisms of RLS.
Abstract
Restless legs syndrome (RLS) is a sensorimotor neurological disorder in which the primary symptom is a compelling urge to move the legs, accompanied by unpleasant and disturbing sensations in the legs. Although pathophysiologic mechanism of RLS is still unclear, several evidences suggest that RLS is related to dysfunction in central nervous system involving brain and spinal cord. 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. Patients with RLS have lower levels of dopamine in the substantia nigra and respond to iron administration. Iron, as a cofactor in dopamine production, plays a central role in the etiology of RLS. Functional neuroimaging studies using PET and SPECT support a central striatal D2 receptor abnormality in the pathophysiology of RLS. Functional MRI suggested a central generator of periodic limb movements during sleep (PLMs) in RLS. However, to date, we have no direct evidence of pathogenic mechanisms of RLS.
참고문헌 (14)
- Hening W., "Impact, diagnosis and treatment of restlesslegs syndrome (RLS) in a primary care population: the REST(RLS epidemiology, symptoms, and treatment) primary carestudy", Sleep Med, 5, pp.237~246 (2004)
- Kohnen R., "The promises of meta-analyses in current RLSresearch: is 1+1 more than 2?", Sleep Med, 9, pp.709~711 (2008)
- Quilici S., "Meta-analysis of theefficacy and tolerability of pramipexole versus ropinirole inthe treatment of restless legs syndrome", Sleep Med, 9, pp.715~726 (2008)
- Allen R., "Dopamine and iron in the pathophysiology of restlesslegs syndrome (RLS)", Sleep Med, 5, pp.385~391 (2004)
- Allen RP, "MRImeasurement of brain iron in patients with restless legs syndrome", Neurology, 56, pp.263~265 (2001)
- Godau J., "Sonographic abnormalitiesof brainstem structures in restless legs syndrome", Sleep Med, 9, pp.782~789 (2008)
- Unrath A., "Symptomatic restless leg syndromeafter lacunar stroke: a lesion study", Mov Disord, 21, pp.2027~2028 (2006)
- Anderson KN, "A case of restless legssyndrome in association with stroke", Sleep, 28, pp.147~148 (2005)
- Sechi G., "Restless legs syndromeand periodic limb movements after ischemic stroke in the rightlenticulostriate region", Parkinsonism Relat Disord, 14, pp.157~160 (2008)
- Trenkwalder C., "Electrophysiologicalpattern of involuntary limb movements in the restless legssyndrome", Muscle Nerve, 19, pp.155~162 (1996)
- Jung KY, "Repetitive legmovements mimicking periodic leg movement during sleep ina brain-dead patient", Eur J Neurol, 13, pp.e3~4 (2006)
- Lee MS, "Sleep-related periodic legmovements associated with spinal cord lesions", Mov Disord, 11, pp.719~722 (1996)
- Bara-Jimenez W., "Periodic limb movements in sleep: state-dependent excitabilityof the spinal flexor reflex", Neurology, 54, pp.1609~1616 (2000)
- Clemens S., "Restless legs syndrome: revisitingthe dopamine hypothesis from the spinal cord perspective", Neurology, 67, pp.125~130 (2006)
