Pathophysiology of restless legs syndrome - the present state of research

The primary pathomechanism of restless legs syndrome is unclear. Neurophysi ological, pharmacological, and imaging studies have demonstrated a complex interaction between central and peripheral structures. The degree of integr ation of central and peripheral mechanisms is not known. Altered excitabili ty at a spinal level modulated by supraspinal rhythms of the brainstem poss ibly plays an important role. There is no anatomical structural lesion and it is more likely that circadian disturbances of dopaminergic and/or opioid ergic neurotransmission are involved.