Restless legs syndrome, neuroleptic-induced akathisia, and opioid-withdrawal restlessness: Shared neuronal mechanisms?

Restlessness is a core symptom underlying restless legs syndrome (RLS), neuroleptic-induced akathisia and opioid withdrawal. These three conditions also share other clinical components suggesting some overlap in their pathophysiology. Recent prospective studies demonstrate the frequent incidence of RLS-like symptoms during opioid withdrawal and supervised prescription opioid tapering. Based also on the therapeutic role of µ-opioid receptor (MOR) agonists in the three clinical conditions and recent pre-clinical experimental data in rodents, we provide a coherent and unifying neuropathological basis for the restlessness observed in these three clinical syndromes and propose a heuristic hypothesis of a key role of the specific striatal neurons that express MORs in akathisia/restlessness.

Informations de copyright

Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.