Hornyak Magdolna, Ahrendts Johannes C, Spiegelhalder Kai, Riemann Dieter, Voderholzer Ulrich, Feige Bernd, van Elst Ludger Tebartz
Center for Sleep Research and Sleep Medicine, Department of Psychiatry and Psychotherapy, University Hospital, Freiburg, Germany.
Sleep Med. 2007 Dec;9(1):22-6. doi: 10.1016/j.sleep.2006.09.010. Epub 2007 May 18.
The pathophysiology of restless legs syndrome (RLS) is not yet understood. A prior voxel-based morphometry (VBM) study reported gray matter increase in the pulvinar of the thalamus in a group of patients, most of whom were on medical treatment. Since there is evidence that medication can change the volume of cerebral structures, the question arises as to whether the reported morphometric alterations are caused by the RLS itself or, alternatively, are a consequence of drug treatment. To address this issue, we performed VBM in unmedicated RLS patients.
Fourteen patients with idiopathic RLS with no (n=11) or only minimal (n=3) treatment exposure in the past and 14 age- and sex-matched healthy subjects were investigated. All subjects were free of psychotropic drugs for at least 4 months. Morphological data were analyzed by using optimized VBM.
We did not detect any structural changes except for slightly increased gray matter density in the ventral hippocampus (p=0.046 on the left and p=0.055 on the right side) and in the middle orbitofrontal gyrus (p=0.046 on the right and p=0.097 on the left side).
Our study could not confirm the findings of a prior study. A possible explanation for the divergent findings is the difference between the populations examined. Since, in our study, essentially treatment-naïve patients were investigated, it is possible that the prior findings reflect treatment-induced effects on cerebral morphology in RLS.
不安腿综合征（RLS）的病理生理学尚未明确。先前一项基于体素的形态学测量（VBM）研究报告称，一组患者丘脑枕的灰质增加，其中大多数患者正在接受药物治疗。由于有证据表明药物可改变脑结构的体积，因此出现了这样一个问题，即所报告的形态学改变是由RLS本身引起的，还是药物治疗的结果。为解决这一问题，我们对未接受药物治疗的RLS患者进行了VBM研究。
对14例特发性RLS患者和14例年龄及性别匹配的健康受试者进行了研究，其中14例患者过去未接受过治疗（n = 11）或仅接受过极少治疗（n = 3）。所有受试者至少4个月未服用精神药物。采用优化的VBM分析形态学数据。
除腹侧海马（左侧p = 0.046，右侧p = 0.055）和眶额中回（右侧p = 0.046，左侧p = 0.097）灰质密度略有增加外，我们未检测到任何结构变化。
我们的研究未能证实先前研究的结果。研究结果存在差异的一个可能解释是所研究人群之间的差异。由于在我们的研究中，研究对象基本上是未接受过治疗的患者，因此先前的研究结果可能反映了RLS中治疗对脑形态的影响。
