Akathisia and Restless Legs Syndrome: Solving the Dopaminergic Paradox

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 tran...

Full description

Saved in:
Bibliographic Details
Published inSleep medicine clinics Vol. 16; no. 2; p. 249
Main Authors Ferré, Sergi, Guitart, Xavier, Quiroz, César, Rea, William, García-Malo, Celia, Garcia-Borreguero, Diego, Allen, Richard P, Earley, Christopher J
Format Journal Article
LanguageEnglish
Published United States 01.06.2021
Subjects
Receptor heteromers
Restless legs syndrome
Striatum
Adenosine
Dopamine
Akathisia
Glutamate
Online AccessGet more information

Cover

More Information
Summary: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.
ISSN:1556-4088
DOI:10.1016/j.jsmc.2021.02.012