Update in restless legs syndrome

Abstract

Purpose of review: Although restless legs syndrome (RLS) is a disorder recognized in the medical literature since the 17th century, there have only recently been significant clinical and scientific advances in diagnosis, epidemiology and understanding the disorder, mainly due to the advent of dopaminergic treatment.

Recent findings: Recent discoveries have uncovered the iron-dopamine connection in RLS and the basic dopaminergic pathology related to the RLS symptoms. These have led to new understanding of the morbidity of RLS and the many conditions associated with RLS, which have also supported new approaches to treatment. These developments are each briefly described here.

Summary: Although there has been progress in understanding, diagnosing and treating RLS, it remains an underdiagnosed and undertreated condition severely impairing functioning of patients with moderate-to-severe disease. Much work is needed to improve on current, as well as other novel therapies.

Figure 1. Model of iron–dopamine relation in restless legs syndrome

Iron decrease also increases circadian amplitude of dopamine (DA) changes from day to night. Postsynaptic adjustment suffices for the increased dopamine in the day, but fails to adjust for the relatively lower dopamine levels at night. DAT, dopamine transporter; 3OMD, 3-O-methyldopa; Th, tyrosine hydroxylase.