Restless legs syndrome

• Published in: Nature reviews. Disease primers Vol. 7; no. 1; p. 80
• Main Authors: Manconi, Mauro, Garcia-Borreguero, Diego, Schormair, Barbara, Videnovic, Aleksandar, Berger, Klaus, Ferri, Raffaele, Dauvilliers, Yves
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03-11-2021; Nature Publishing Group
• Subjects: 692/617/375/1816; 692/617/375/346; Age; Brain; Cancer Research; Comorbidity; Diabetes; Disease; Dopamine; Dopamine Agonists; Dopamine Agonists - therapeutic use; Epidemiology; Family medical history; Health risk assessment; Human health and pathology; Humans; Insomnia; Internal Medicine; Iron; Life Sciences; Longitudinal studies; Medical Microbiology; Medicine; Medicine & Public Health; Pathophysiology; Primer; Quality of Life; Quality of Life Research; Restless Legs Syndrome; Restless Legs Syndrome - diagnosis; Restless Legs Syndrome - epidemiology; Sleep; Womens health
• ISSN: 2056-676X; 2056-676X
• DOI: 10.1038/s41572-021-00311-z

Restless legs syndrome (RLS) is a common sensorimotor disorder characterized by an urge to move that appears during rest or is exacerbated by rest, that occurs in the evening or night and that disappears during movement or is improved by movement. Symptoms vary considerably in age at onset, frequency and severity, with severe forms affecting sleep, quality of life and mood. Patients with RLS often display periodic leg movements during sleep or resting wakefulness. RLS is considered to be a complex condition in which predisposing genetic factors, environmental factors and comorbidities contribute to the expression of the disorder. RLS occurs alone or with comorbidities, for example, iron deficiency and kidney disease, but also with cardiovascular diseases, diabetes mellitus and neurological, rheumatological and respiratory disorders. The pathophysiology is still unclear, with the involvement of brain iron deficiency, dysfunction in the dopaminergic and nociceptive systems and altered adenosine and glutamatergic pathways as hypotheses being investigated. RLS is poorly recognized by physicians and it is accordingly often incorrectly diagnosed and managed. Treatment guidelines recommend initiation of therapy with low doses of dopamine agonists or α
2
δ ligands in severe forms. Although dopaminergic treatment is initially highly effective, its long-term use can result in a serious worsening of symptoms known as augmentation. Other treatments include opioids and iron preparations.
Restless legs syndrome is a common disorder that is characterized by an urge to move the legs. This Primer reviews the epidemiology, mechanisms, diagnosis and treatment of restless legs syndrome, and also summarizes the quality-of-life issues faced by patients and future research avenues.