Sensory aspects of restless legs syndrome: Clinical, neurophysiological and neuroimaging prospectives

IF 11.2 1区 医学 Q1 CLINICAL NEUROLOGY
Elena Antelmi , Maria P. Mogavero , Giuseppe Lanza , Sandy M. Cartella , Luigi Ferini-Strambi , Giuseppe Plazzi , Raffaele Ferri , Michele Tinazzi
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Abstract

Restless Legs Syndrome (RLS) is a complex sensorimotor disorder, classified among the sleep-related movement disorders. Although sensory symptoms appear as key features of the disorder, they are still poorly characterized from a clinical perspective and conceptualized from a pathophysiological point of view. In this review, we aim to describe the clinical and functional substrates of RLS, focusing mainly on its sensory symptoms and on their neurophysiological and anatomical correlates. Knowledge of both subjective sensory symptoms and objective sensory signs are still controversial. Current data also indicate that the sensory component of RLS seems to be subserved by anomalies of sensorimotor integration and by mechanism of central sensitization. Overall, electrophysiological findings highlight the involvement of multiple generators in the pathogenesis of RLS, eventually resulting in an increased nervous system excitability and/or alterations in inhibition within the somatosensory and nociceptive pathways. Structural and functional neuroimaging data show the involvement of several crucial areas and circuits, among which the thalamus appears to play a pivotal role. A holistic approach looking at brain connectivity, structural or functional abnormalities, and their interplay with molecular vulnerability and neurotransmitter alterations is warranted to disentangle the complex framework of RLS.

不宁腿综合征的感官方面:临床、神经生理学和神经影像学展望。
不安腿综合征(RLS)是一种复杂的感觉运动障碍,属于睡眠相关运动障碍。虽然感觉症状是该疾病的主要特征,但从临床角度和病理生理学角度来看,这些症状的特征还很不明显。在这篇综述中,我们旨在描述 RLS 的临床和功能基础,主要侧重于其感觉症状及其神经生理学和解剖学相关性。关于主观感觉症状和客观感觉体征的知识仍存在争议。目前的数据还表明,RLS 的感觉症状似乎是由感觉运动整合异常和中枢敏感化机制引起的。总之,电生理学研究结果表明,RLS 的发病机制涉及多个发生器,最终导致神经系统兴奋性增高和/或躯体感觉和痛觉通路抑制的改变。结构和功能神经影像学数据显示,有几个关键区域和回路参与其中,其中丘脑似乎起着关键作用。我们有必要采用一种整体方法来研究大脑连接、结构或功能异常,以及它们与分子脆弱性和神经递质改变之间的相互作用,从而揭示 RLS 的复杂框架。
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来源期刊
Sleep Medicine Reviews
Sleep Medicine Reviews 医学-临床神经学
CiteScore
20.10
自引率
3.80%
发文量
107
期刊介绍: Sleep Medicine Reviews offers global coverage of sleep disorders, exploring their origins, diagnosis, treatment, and implications for related conditions at both individual and public health levels. Articles comprehensively review clinical information from peer-reviewed journals across various disciplines in sleep medicine, encompassing pulmonology, psychiatry, psychology, physiology, otolaryngology, pediatrics, geriatrics, cardiology, dentistry, nursing, neurology, and general medicine. The journal features narrative reviews, systematic reviews, and editorials addressing areas of controversy, debate, and future research within the field.
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