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Update on Restless Legs Syndrome: from Mechanisms to Treatment

  • Movement Disorders (T. Simuni, Section Editor)
  • Published:
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Abstract

Purpose of Review

To provide an overview of the molecular pathways and recent genetic risk loci associated with restless legs syndrome/Willis-Ekbom disease (RLS/WED) and describe the most recent treatment guidelines.

Recent Findings

Diagnostic criteria for RLS/WED now include a fifth criterion to differentiate from RLS/WED mimics. Our understanding of disease pathophysiology has improved, specifically regarding iron regulation in the brain and the role of other pathways such as opioid signaling and brain and spinal cord circuitry may play. Finally, several genetic risk loci have been described, including MEIS1 which is currently considered to be the strongest genetic risk factor for RLS/WED. Treatment guidelines now suggest α2δ ligands such as gabapentin enacarbil should be used as first-line treatment.

Summary

The current literature focuses on disease pathways as well as the development of animal models based on genetic risk factors for RLS/WED. Updated treatment guidelines expand on first-line treatment options.

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  1. Department of Neurology, Feinberg School of Medicine, Chicago, IL, USA

    Paulina Gonzalez-Latapi & Roneil Malkani

  2. Center for Circadian and Sleep Medicine, Northwestern University, Chicago, IL, USA

    Roneil Malkani

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Roneil Malkani reports grant support from the Alzheimer’s Association, Illinois Department of Public Health, National Institutes of Health, and Northwestern University Parkinson’s Disease Advisory Council, and speaking honoraria for Advocate Healthcare and for American Academy of Neurology. Paulina Gonzalez-Latapi declares no potential conflicts of interest.

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Gonzalez-Latapi, P., Malkani, R. Update on Restless Legs Syndrome: from Mechanisms to Treatment. Curr Neurol Neurosci Rep 19, 54 (2019). https://doi.org/10.1007/s11910-019-0965-4

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