Restlessness: The Anatomy of a Neuropsychiatric Symptom

Abstract

Objective: The aim of the paper is to review the literature on restlessness and related syndromes in order to examine the different causes and clinical descriptions, and to present a pathogenetic model that would incorporate its diverse aetiology. Method: A literature search was undertaken with restlessness, agitation, akathisia, hyperactivity, fidgetiness and jitteriness as key words. Results: Causes of restlessness are diverse, and its distinction from other descriptions, such as agitation and hyperactivity, is poorly defined in the literature. Detailed descriptions of the syndromes are therefore lacking. The neuroanatomical basis of restlessness may consist of abnormalities in the corticc-subcortical neuronal circuits, the complex regulation of which may explain why different causes often lead to a common end result. Conclusions: The terms used to describe restlessness and related disorders should be standardised, and the clinical manifestations investigated pedanti- cally. Human and animal studies should investigate the pathophysiology so that intervention can be based on the underlying mechanisms.