Augmentation in patients with restless legs syndrome receiving pramipexole therapy: a retrospective study in a single center from China

Wang, Tiantian; Ying, Miaofa; Zhao, Rui; Zhu, Danyan; Zhang, Lisan

doi:10.1007/s11325-021-02353-9

Cited by 1 publication

(2 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Restless legs syndrome, also known as Willis-Ekbom disease (WED), is a sensorimotor disorder characterized by an irresistible urge to move the legs, worsening symptoms at night, and for some patients, unpleasant sensations in the legs. The disorder affects an estimated 1-15.3% of the population, with about 1-3% of people overall experiencing severe and frequent symptoms (1)(2)(3)(4)(5)(6)(7). Despite the prevalence of the syndrome, the cause of RLS syndrome remains ambiguous from both clinical and pathophysiological perspectives.…”

Section: Introductionmentioning

confidence: 99%

“…However, evaluating the prevalence of augmentation poses challenges due to various influencing factors, including medication type and dosage, study duration and design, assessment criteria, and sample size (11). Specifically, augmentation rates have been found to rise with study duration: short-term studies report rates of 10% (22-26), studies lasting 2-3 years report rates of 15-30%, and studies lasting around 10 years report rates of 42-68% (6,27,28). Here, we provide a summary of mechanisms, including dopamine release efficiency, dopamine receptor sensitivity and interaction, genetic risk factors for RLS, iron deficiency, vitamin D deficiency and circadian rhythms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring the causes of augmentation in restless legs syndrome

Zeng,

Wang,

Zhang

et al. 2023

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

Long-term drug treatment for Restless Legs Syndrome (RLS) patients can frequently result in augmentation, which is the deterioration of symptoms with an increased drug dose. The cause of augmentation, especially derived from dopamine therapy, remains elusive. Here, we review recent research and clinical progress on the possible mechanism underlying RLS augmentation. Dysfunction of the dopamine system highly possibly plays a role in the development of RLS augmentation, as dopamine agonists improve desensitization of dopamine receptors, disturb receptor interactions within or outside the dopamine receptor family, and interfere with the natural regulation of dopamine synthesis and release in the neural system. Iron deficiency is also indicated to contribute to RLS augmentation, as low iron levels can affect the function of the dopamine system. Furthermore, genetic risk factors, such as variations in the BTBD9 and MEIS1 genes, have been linked to an increased risk of RLS initiation and augmentation. Additionally, circadian rhythm, which controls the sleep–wake cycle, may also contribute to the worsening of RLS symptoms and the development of augmentation. Recently, Vitamin D deficiency has been suggested to be involved in RLS augmentation. Based on these findings, we propose that the progressive reduction of selective receptors, influenced by various pathological factors, reverses the overcompensation of the dopamine intensity promoted by short-term, low-dose dopaminergic therapy in the development of augmentation. More research is needed to uncover a deeper understanding of the mechanisms underlying the RLS symptom and to develop effective RLS augmentation treatments.

show abstract