Lower limb flexor reflex: Comparisons between drug-induced akathisia and restless legs syndrome.

Abstract:

BACKGROUND AND OBJECTIVE:Akathisia is characterized by restlessness and crawling sensations similar to restless legs syndrome (RLS). Long latency flexor reflex (LLFR) which has helped to advance RLS pathophysiology has never been investigated in akathisia. Due to the clinical commonalities of akathisia and RLS, we investigated the behavior of LLFR in patients with akathisia aiming to understand pathophysiology of akathisia. PATIENTS AND METHODS:Seven patients with neuroleptic-induced akathisia, 12 drug-naïve patients with primary RLS and 17 healthy subjects were prospectively enrolled in the study. LLFR was recorded from unilateral tibialis anterior (TA) and long head of biceps femoris (BF) muscles after stimulating the sole by trains of electrical stimuli. We measured amplitude, latency, duration, presence of response and compared between three groups. RESULTS:One-way ANOVA showed mean durations of early and late responses recorded over TA were the longest in akathisia group compared to both RLS group and healthy subjects (p=0.012). The spatial spread of LLFR in akathisia patients was comparable to those of healthy subjects whereas presence of response on BF was significantly less in akathisia than RLS group. CONCLUSIONS:Our findings indicate increased excitability of LLFR pathway in akathisia group. These findings are probably due to lack of inhibition originated in regions other than those known to downregulate in RLS.

journal_name

Neurosci Lett

journal_title

Neuroscience letters

authors

Gunduz A,Metin B,Metin SZ,Poyraz BC,Karadeniz D,Kiziltan G,Kiziltan ME

doi

10.1016/j.neulet.2017.01.042

subject

Has Abstract

pub_date

2017-02-22 00:00:00

pages

40-44

eissn

0304-3940

issn

1872-7972

pii

S0304-3940(17)30062-9

journal_volume

641

pub_type

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